Utility of two-view vs. three-view abdominal radiography in canines presenting with acute abdominal signs

There are clear differences in the normal radiographic appearance of the abdominal organs between a left lateral vs. a right lateral view. While a few veterinary academic institutions have transitioned to a three-view abdominal radiographic study protocol, obtaining only two views of the canine abdomen remains the current standard in veterinary medicine. In this combined retrospective and prospective, case-controlled study, 48 canine patients presenting with signs of acute abdomen were recruited. Four board-certified veterinary radiologists and four general practice veterinarians with greater than 3 years of experience in small animal practice were asked to determine if 10 predetermined findings were present within the set of images and if surgery was recommended based on those findings. Image readers were unaware of the clinical history. Three-view studies did not yield statistically significantly greater accuracy than two-view studies when evaluating all readers together. No statistically significant associations between the availability of the third view and increased accuracy or confidence were found in evaluations of general practitioners specifically. Evaluation of three-view radiographic examination, as compared to two-view examination, did not have perceived or statistically significantly increased diagnostic utility. Based on our findings, there is no statistically increased utility to justify a standard three-view abdominal radiographic examination over a two-view study for canines presenting with signs of acute abdomen.