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Sensitivity, specificity, and interobserver variability of survey thoracic radiography for the detection of heart base masses in dogs

Carlo GuglielminiDepartment of Veterinary Clinical Sciences, University of Teramo, 64100 Teramo, Italy.

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Marco Baron ToaldoDepartment of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, 40064 Ozzano Emilia, Italy.

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Manuela QuinciDepartment of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, 40064 Ozzano Emilia, Italy.

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Giovanni RomitoDepartment of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, 40064 Ozzano Emilia, Italy.

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Alessia LucianiDepartment of Veterinary Clinical Sciences, University of Teramo, 64100 Teramo, Italy.

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Mario CiponeDepartment of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, 40064 Ozzano Emilia, Italy.

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Michele DrigoDepartment of Animal Medicine, Production and Health, University of Padova, 35020 Legnaro (PD), Italy.

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Alessia DianaDepartment of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, 40064 Ozzano Emilia, Italy.

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Abstract

OBJECTIVE To determine the sensitivity, specificity, and interobserver variability of survey thoracic radiography (STR) for the detection of heart base masses (HBMs) in dogs.

DESIGN Retrospective case-control study.

ANIMALS 30 dogs with an HBM and 120 breed-matched control dogs (60 healthy dogs and 60 dogs with heart disease and no HBM).

PROCEDURES In a blinded manner, 2 observers (designated as A and B) evaluated STR views from each dog for a mass-like opacity cranial to the heart, tracheal deviation, cardiomegaly, findings suggestive of pericardial effusion or right-sided congestive heart failure, and soft tissue opacities suggestive of pulmonary metastases. Investigators subsequently provided a final interpretation of each dog's HBM status (definitely affected, equivocal, or definitely not affected).

RESULTS Considering equivocal interpretation as negative or positive for an HBM, the sensitivity of STR for diagnosis of an HBM was 40.0% (95% confidence interval [CI], 22.5% to 57.5%) and 56.7% (95% CI, 38.9% to 74.4%), respectively, for observer A and 63% (95% CI, 46.1% to 80.6%) and 80.0% (95% CI, 65.7% to 94.3%), respectively, for observer B. The corresponding specificity was 96.7% (95% CI, 93.5% to 99.9%) and 92.5% (95% CI, 87.8% to 97.2%), respectively, for observer A and 99.2% (95% CI, 97.5% to 100%) and 92.5% (95% CI, 87.8% to 97.2%), respectively, for observer B. The presence of a mass-like opacity cranial to the heart or tracheal deviation, or both, was significantly associated with a true diagnosis of HBM.

CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that STR is a highly specific but not a highly sensitive predictor of HBM in dogs.

Abstract

OBJECTIVE To determine the sensitivity, specificity, and interobserver variability of survey thoracic radiography (STR) for the detection of heart base masses (HBMs) in dogs.

DESIGN Retrospective case-control study.

ANIMALS 30 dogs with an HBM and 120 breed-matched control dogs (60 healthy dogs and 60 dogs with heart disease and no HBM).

PROCEDURES In a blinded manner, 2 observers (designated as A and B) evaluated STR views from each dog for a mass-like opacity cranial to the heart, tracheal deviation, cardiomegaly, findings suggestive of pericardial effusion or right-sided congestive heart failure, and soft tissue opacities suggestive of pulmonary metastases. Investigators subsequently provided a final interpretation of each dog's HBM status (definitely affected, equivocal, or definitely not affected).

RESULTS Considering equivocal interpretation as negative or positive for an HBM, the sensitivity of STR for diagnosis of an HBM was 40.0% (95% confidence interval [CI], 22.5% to 57.5%) and 56.7% (95% CI, 38.9% to 74.4%), respectively, for observer A and 63% (95% CI, 46.1% to 80.6%) and 80.0% (95% CI, 65.7% to 94.3%), respectively, for observer B. The corresponding specificity was 96.7% (95% CI, 93.5% to 99.9%) and 92.5% (95% CI, 87.8% to 97.2%), respectively, for observer A and 99.2% (95% CI, 97.5% to 100%) and 92.5% (95% CI, 87.8% to 97.2%), respectively, for observer B. The presence of a mass-like opacity cranial to the heart or tracheal deviation, or both, was significantly associated with a true diagnosis of HBM.

CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that STR is a highly specific but not a highly sensitive predictor of HBM in dogs.

Contributor Notes

Dr. Guglielmini's present address is Department of Animal Medicine, Production and Health, University of Padova, Viale dell'Università 16- Agripolis, I-35020 Legnaro (PD), Italy.

Address correspondence to Dr. Guglielmini (carlo.guglielmini@unipd.it).