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Can malignant and inflammatory pleural effusions in dogs be distinguished using computed tomography?
Thom C Watton1, Ana Lara-Garcia1, Christopher R Lamb1
1Department of Clinical Sciences and Services, The Royal Veterinary College, University of London, Hertfordshire AL9 7TA, UK.
Summary
Computed tomography (CT) can help differentiate malignant pleural neoplasia from pleuritis in dogs. Key signs include older patient age, marked parietal pleural thickening, and thoracic wall invasion on CT scans.
Area of Science:
- Veterinary Radiology
- Canine Oncology
- Diagnostic Imaging
Background:
- Computed tomography (CT) is crucial for diagnosing pleural effusion in humans, but its application in canine diagnostics remains underexplored.
- Distinguishing malignant pleural neoplasia from inflammatory pleuritis in dogs using CT is challenging due to overlapping imaging findings.
Purpose of the Study:
- To identify specific computed tomography (CT) imaging features that differentiate malignant pleural neoplasia from pleuritis in dogs.
- To establish CT-based criteria for improving the diagnostic accuracy of canine pleural effusion.
Main Methods:
- A retrospective case-control study analyzed pre- and postcontrast thoracic CT images from dogs with confirmed malignant or inflammatory pleural effusion.
- Dogs were categorized based on cytological or histopathological diagnoses, including mesothelioma, carcinoma, lymphoma, pyothorax, and chylothorax.
Main Results:
- Dogs with malignant pleural effusion were significantly older and more likely to exhibit marked pleural thickening, particularly of the parietal pleura alone, compared to dogs with pleuritis.
- Computed tomography (CT) signs of thoracic wall invasion were exclusively observed in dogs with malignant pleural effusions.
- No significant differences were found in pleural fluid volume, distribution, attenuation, contrast enhancement, pannus, or mediastinal lymphadenopathy between the groups.
Conclusions:
- While overlap exists, marked parietal pleural thickening and signs of thoracic wall invasion on CT scans are indicative of malignant pleural neoplasia in dogs.
- These CT findings can aid in prioritizing further diagnostic investigations for canine pleural effusion.
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