Objective—To compare calibration methods for digital radiography in terms of measurement accuracy and interobserver variability.
Sample—Digital radiographic images of a 155-mm-long Steinmann pin.
Procedures—Measurement of pin length on digital radiographs was determined with a 25.4-mm-diameter calibration ball and commercially available software program via 3 calibration methods (ie, no calibration, autocalibration, and manual calibration). Digital radiographs of the calibration ball and pin were obtained with each placed at various vertical heights from the table (7 heights) and horizontal distances from the center of the beam (4 distances). Measurements of pin length on digital radiographs were made by 4 observers who were blinded to the orientation of the calibration ball and pin.
Results—Pin lengths obtained by each calibration method were significantly different from each other and from the true value. Manual calibration was the most accurate. There was no significant interobserver variability in measurements. There was no significant change in measurements when the calibration ball was moved horizontally, but pin length measurements changed significantly when the ball was moved vertically (away from the table) with an approximate magnification error of 1% per centimeter of distance between the calibration ball and pin.
Conclusions and Clinical Relevance—For digital radiography, manual calibration is recommended to achieve the most accurate measurements. Ideally, the calibration ball should be placed at the same vertical height as the object to be measured; however, if this cannot be achieved, the magnification error can be expected to be approximately 1% per centimeter of distance.
Case Description—A 9-year-old castrated male mixed-breed dog and a 7-year-old spayed female Boston Terrier, with clinical histories of a liver mass (dog 1) and bloody vomitus, diarrhea, and weight loss (dog 2), respectively, were referred for further evaluation.
Clinical Findings—At the time of referral, each dog had differing laboratory abnormalities; however, the serum total protein and globulin concentrations were within reference range in both dogs. Cytologic examination of fine-needle aspirates obtained from affected organs (a liver mass [dog 1] and enlarged submandibular lymph node [dog 2]) revealed 2 main nucleated cell types: atypical lymphoid cells and lesser numbers of Mott cells. With the use of serum immunofixation electrophoresis and serum immunoglobulin quantification, a monoclonal immunoglobulin protein was identified in both dogs and a final diagnosis of secretory B-cell lymphoma with Mott cell differentiation (MCL) was made.
Treatment and Outcome—Both dogs received chemotherapy for their disease. The first dog was euthanized 8.5 months after diagnosis because of acute respiratory distress of unknown etiology, and the second was euthanized 7 days after diagnosis for worsening clinical disease and quality of life.
Clinical Relevance—To our knowledge, this report is the first of a secretory form of MCL in dogs. Findings indicate that in dogs with suspect MCL, even in patients that lack characteristic hyperproteinemia or hyperglobulinemia, serum protein content should be fully evaluated for the presence of a monoclonal immunoglobulin protein. Such an evaluation that uses immunofixation electrophoresis and immunoglobulin quantification will aid in the diagnosis of MCL in dogs.
Case Description—A 12-year-old castrated male Labrador Retriever was evaluated for clinical signs associated with colorectal obstruction.
Clinical Findings—The dog had a 2-week history of tenesmus and hematochezia. On rectal examination, an annular colorectal mass was palpable extending orad into the pelvic canal. The original diagnosis of the colorectal mass was a mucosal adenoma. The dog was maintained on a low-residue diet and fecal softeners for a period of 13 months after initial diagnosis. At that time, medical management was no longer effective.
Treatment and Outcome—Placement of a colonic stent was chosen to palliate the clinical signs associated with colorectal obstruction. By use of fluoroscopic and colonoscopic guidance, a nitinol stent was placed intraluminally to open the obstructed region. Placement of the stent resulted in improvement of clinical signs, although tenesmus and obstipation occurred periodically after stent placement. At 212 days after stent placement, the patient had extensive improvement in clinical signs with minimal complications; however, clinical signs became severe at 238 days after stent placement, and the dog was euthanized. Histologic evaluation of the rectal tumor from samples obtained during necropsy revealed that the tumor had undergone malignant transformation to a carcinoma in situ.
Clinical Relevance—A stent was successfully placed in the colon and rectum to relieve obstruction associated with a tumor originally diagnosed as a benign neoplasm. Placement of colorectal stents may be an option for the palliation of colorectal obstruction secondary to neoplastic disease; however, clinical signs may persist, and continuation of medical management may be necessary.