Accuracy of Plain Digital Radiography for the Detection of Gastrointestinal Masses in Dogs and Cats

Abdominal radiography is commonly used as an initial diagnostic tool in dogs and cats with gastrointestinal (GI) signs. Historically, abdominal radiographs were considered unreliable for detecting GI masses, with detection rates below 50%. The purpose of this retrospective, case-control study was to determine the accuracy of abdominal radiographs in identifying the presence and location of GI masses and to assess the influence of the reviewer experience. Radiographs from 114 dogs and 111 cats were reviewed by two board-certified radiologists, one first year radiology resident, and one rotating intern. Patients were categorized into three groups: animals with a GI mass greater than 2 cm (dogs n = 44; cats n = 41), animals with a normal abdomen (both n = 50), and animals with abdominal disease but no GI mass (both n = 20). Reviewers demonstrated high specificity but low sensitivity for both detection and localization of GI masses. Sensitivity for detecting a mass ranged from 34 to 64% in dogs and 36 to 71% in cats; specificity exceeded 87% in dogs and 92% in cats. Sensitivity for location identification ranged from 9 to 58% in dogs and 21 to 68% in cats; specificity exceeded 76% in dogs and 81% in cats. No statistically significant differences in detection rates were found among reviewers. The accuracy of plain digital radiography for the detection of gastrointestinal masses in dogs (75%) and cats (81%) is better than previously reported film radiography but remains inferior to other imaging modalities. However, its high specificity supports its clinical utility in ruling out gastrointestinal masses.