Multi-site bone marrow core biopsy improves diagnostic accuracy in dogs with hematologic disease

Area of Science:

• Veterinary Pathology
• Hematology
• Diagnostic Imaging

Background:

• Bone marrow's spatial heterogeneity impacts diagnostic accuracy in veterinary medicine.
• Single-site sampling may miss focal disease in dogs, creating a diagnostic gap.
• Optimal bone marrow sampling strategies for canine hematologic disease are unclear.

Purpose of the Study:

• To evaluate the diagnostic capture probability of sampling one to four bone marrow sites in dogs.
• To compare multi-site bone marrow core sampling against single-site standards for canine hematologic disease diagnosis.

Main Methods:

• Sixteen dogs with suspected hematologic disease underwent bone marrow biopsies from four anatomical locations.
• Two pathologists independently evaluated 64 masked bone marrow samples.
• Diagnostic accuracy was assessed using truth set methodology and statistical analysis.

Main Results:

• Multi-site bone marrow core sampling significantly improved diagnostic capture probability.
• Increasing sampling from one to two sites improved diagnostic accuracy by 18.2% (permissive rule) and 19.8% (pathologist agreement).
• Site-specific differences in myeloid-to-erythroid ratios and megakaryocyte counts were observed.

Conclusions:

• Multi-site bone marrow core sampling offers clinically meaningful improvements in diagnostic accuracy for canine hematologic diseases.
• The greatest diagnostic benefit is achieved by adding a second sampling site to existing single-site protocols.