USE OF 123IODINE METAIODOBENZYLGUANIDINE SCINTIGRAPHY FOR THE DIAGNOSIS OF A PHEOCHROMOCYTOMA IN A DOG

A 13-year-old neutered female Yorkshire terrier presented with a history of progressive episodic weakness and disorientation of 4 months duration. Physical and neurologic examinations were normal at presentation. Abdominal ultrasound revealed a mass involving the right adrenal gland. Standard planar scintigraphy was performed at 4, 18, and 24 hours after intravenous injection 185 MBq (5mCi) of ¹²³I-labeled metaiodobenzylguanidine (¹²³I-MIBG). An area of focal intense uptake was identified in the area of the right adrenal gland. A pheochromocytoma was confirmed histologically after surgical excision.     

QUANTITATIVE HEPATIC SCINTIGRAPHY IN THE DOG

Quantitative hepatic scintigraphy is a noninvasive test for measurement of relative arterial and portal blood flow to the liver. This technique has been used to evaluate human patients with known or suspected liver tumors or diffuse hepatocellular disease. A computer program to assess the hepatic perfusion index (HPI) in the normal dog is described. Factors affecting study quality and accuracy include injection technique, cardiac function, patient position, respiration, gross patient motion, and user intervention during data processing. HPI for a group of 12 normal dogs was 0.9±0.4 (X±SD). Quantitative scintigraphy could be used to evaluate dogs with primary or secondary liver tumors, portacaval shunts, or chronic liver disease     

COMPUTED TOMOGRAPHY DIAGNOSIS OF ISOLATED SPLENIC TORSION IN A DOG

Isolated splenic torsion in a dog was diagnosed using computed tomography (CT). The enlarged non enhanced spleen and a twisted soft tissue mass effect represented the rotated pedicle were the main findings. Abdominal radiography and ultrasonography were not conclusive.     

QUANTITATIVE HEPATOBILIARY SCINTIGRAPHY WITH DECONVOLUTIONAL ANALYSIS FOR THE MEASUREMETN OF HEPATIC FUNCTION IN DOGS

A nuclear medicine procedure that has been used for quantification of hepatocyte function in man is applied and validated in the dog. This procedure employs deconvolutional analysis of liver and heart time activity curves obtained following peripheral intravenous injection of hepatobiliary radiopharmaceutical. The deconvolutional analysis simulates a bolus injection of the radiopharmaceutical into the afferent blood supple of the liver which permits the calculation of the hepatic extraction fraction. Hepatic extraction fraction is a measure of hepatocyte function. In this report, the deconvolutional analysis via fast Fourier transformations and subsequent calculation of hepatic extraction fraction is validated by direct afferent intravascular ijection of ^99mTc-mebrofenin. The hepatic extraction fraction determined via deconvolutional analysis was found to be the same as the first pass hepatic extraction fraction determined via deconvolutional analysis was found to be the same as the first pass hepatic extraction fraction determined by direct mesenteric (portal) vein injection. The same results can be obtained in a sedated animal, making the technique clinically applicable. Thus hepatic extraction fraction, obtained from a perlpheral intravenous injection of ^99mTc-mebrofenin, can provide a quatitative measure of hepatocyte function from a non-invasive procedure. The quantitative ability to measure hepatocyte function has potential in many clinical and research situations.     

THE HILAR PERIVENOUS HYPERECHOIC TRIANGLE AS A SIGN OF ACUTE SPLENIC TORSION IN DOGS

Diagnosis of acute primary splenic torsion is challenging. The ultrasonographic appearance of this condition has been described, but other splenic diseases, such as diffuse infarction because of thrombosis, can appear very similar. We describe an additional ultrasonographic sign of acute splenic torsion; a triangular hyperechoic area at the hilus between the veins and the splenic parenchyma that is continuous with the hyperechoic mesentery. In a group of animals where acute splenic torsion was part of the ultrasound report differential diagnosis, we compared findings in dogs with torsion with findings in dogs with other splenic conditions. The presence of a hilar hyperechoic perivenous triangle was significantly associated with splenic torsion (P = 0.005). We speculate that this sign is associated with torsion because of the secondary severe, diffuse splenic enlargement. Although not pathognomonic, this sign could be used to more accurately diagnose splenic torsion in light of other findings consistent with this condition.     

A COMPARISON OF IOPAMIDOL AND METRIZAMIDE FOR CERVICAL MYELOGRAPHY IN THE DOG

Cervical myelography using iopamidol, a new nonionic contrast medium, was studied in nine dogs. Postmyelographic seizure activity, motor evoked potentials, and rectal temperatures were monitored, and myelographic quality was subjectively evaluated. The results were compared with data from eight dogs that had metrizamide myelography. The iopamidol group had fewer seizures ( p < 0.01) but exhibited no difference in motor evoked potential or rectal temperature recordings. Myelographic quality was similar for iopamidol and metrizamide. The study suggests that iopamidol was less neurotoxic than metrizamide for canine cervical myelography.     

QUANTITATIVE HEPATOBILIARY SCINTIGRAPHY USING 99mTC-DISIDA IN THE DOG

Quantitative hepatobiliary scintigraphy using ^99mTc-2,6 diisopropylphenylcarbamoylmethyl iminodiacetic acid (DISIDA) was performed in normal dogs. ^99mTc-DISIDA is excreted by the hepatocyte into the biliary tract. Hepatic blood flow from arterial and portal venous sources was measured as the hepatic perfusion index. The hepatic clearance of the radiopharmaceutical was used to assess hepatocyte function and parenchymal biliary transport. Biliary ejection was evaluated using synthetic cholecystokinin infusion. The procedure should be useful in evaluating dogs with hepatic and biliary disease.     

B-MODE AND DOPPLER ULTRASOUND IMAGING OF THE SPLEEN WITH CANINE SPLENIC TORSION: A RETROSPECTIVE EVALUATION

The ultrasonographic appearance of splenic torsion has been described; the splenic parenchyma can be normal, hypoechoic or anechoic with interspersed linear echoes (coarse/"lacy" appearance). The ultrasonographic parenchymal appearance of 15 dogs in this report with splenic torsion varied: mottled hypoechoic regions (n=2), diffusely hypoechoic (n=11) and normal (n=2). Because splenic torsion causes vascular congestion due to splenic vein compression and eventual thrombosis, visible splenic vein intraluminal echogenicities compatible with thrombi were seen in 13 dogs using B-mode. Using spectral Doppler and color Doppler imaging of the splenic veins, no measurable flow velocities were detected in any of the 15 dogs. The varied B-mode ultrasonographic appearance of the splenic veins for intraluminal echoes and spectral or color Doppler evaluation for absent velocity flow.     

ULTRASONIC DETECTION OF SPLENIC NECROSIS IN THE DOG

Ultrasonographic findings of splenic infarction and necrosis in three dogs are presented. Two previously unreported ultrasonographic patterns are identified: (1) Focal, hypoechoic or isoechoic, circular, wellmarginated nodular masses with peripheral lesions causing deformation of the splenic margin. (2) Diffuse hypoechoic or heteroechoic coarse/"lacy" parenchymal pattern with no deformation of margin. The presence of gas within the splenic parenchyma of one dog was detected by both radiography and ultrasonography. Ultrasonographic patterns of splenic infarction in both man and the dog are discussed     

OSTEOSARCOMA IN THE MIDDIAPHYSIS OF THE RADIUS IN THE DOG

This case report describes the radiographic/clinical progression of a lesion in the middiaphysis of the radius in a dog. The lesion initially looked benign but progressed and eventually was diagnosed as an anaplastic osteosarcoma.     

SCINTIGRAPHIC DETECTION OF SUBCUTANEOUS METASTASIS IN A DOG WITH APPENDICULAR OSTEOSARCOMA

This report describes the detection of subclinical soft tissue metastasis of an appendicular osteosarcoma in a dog using bone scintigraphy. A 7-year-old spayed female Rottweiler was presented with a biopsy confirmed diagnosis of osteosarcoma. Initial radiographs revealed an aggressive bone lesion of the left distal radius. At presentation, there was no clinical or radiographic evidence of metastasis; however, a nuclear bone scan showed the primary bone lesion of the distal left radius and numerous soft tissue lesions consistent with diffuse soft tissue metastases. A left foreleg amputation was performed and cisplatin chemotherapy was given post-operatively. A second bone scan performed one month following initial presentation showed progression in size and number of soft tissue masses. Many of the lesions had become apparent on physical exam and survey radiographs. Excisional biopsy was performed on one of the soft tissue masses and a diagnosis of metastatic osteosarcoma was made. The dog was euthanized 2 months after initial presentation at the owners request due to deterioration of the animals physical condition.     

HEMANGIOSARCOMA IN THE MAIN PULMONARY ARTERY OF A DOG

The clinical, radiological and necropsy findings in a five-year old dog with a hemangiosarcoma in the main pulmonary artery are described. Hemangiosarcoma in this location has not been previously described in the dog, the typical location in the heart being the right atrium and auricle. The tumor in this dog caused both a perfusion deficit to the right lung and obstruction of right ventricular outflow, which eventually caused right heart failure.     

COMPARISON OF PER-RECTAL PORTAL SCINTIGRAPHY USING 99mTECHNETIUM PERTECHNETATE TO MESENTERIC INJECTION OF RADIOACTIVE MICROSPHERES FOR QUANTIFICATION OF PORTOSYSTEMIC SHUNTS IN AN EXPERIMENTAL DOG MODEL

Per-rectal portal scintigraphy using tech-netium-99m pertechnetate (^99mTcO₄^-) was performed in 8 normal dogs before and after surgical creation of a portacaval shunt. Shunt fractions were calculated by computer assisted analysis of dynamic images (IMG) and compared to shunt fractions determined by mesenteric venous injection of radioactive microspheres (MIC). The mean pre-operative shunt fraction was 1.59% using IMG and 3.00% using MCI. The mean postoperative shunt fraction was 64.56% using IMG and 69.56% using MIC. There was excellent correlation between both methods (r² 0.94). Per-rectal portal scintigraphy is an easily performed, inexpensive method to diagnose and quantify portosystemic shunts in dogs.     

THE EFFECTS OF INTRA-ARTICULAR ANESTHESIA ON SOFT TISSUE-AND BONE-PHASE SCINTIGRAPHY IN THE HORSE

Soft tissue- and bone-phase scintigrams were acquired from 4 normal horses before and over a 14-day period after metacarpophalangeal, antebrachiocarpal, tarsocrural and tarsometatarsal joint blocks. Images were evaluated subjectively and quantitatively for increased activity in these regions. The antebrachiocarpal block resulted in obvious focal accumulation of activity on soft tissue-phase scintigrams. This increased activity was greatest 2 to 4 days postanesthesia and persisted up to 14 days postanesthesia. On quantitative analysis of soft tissue-phase images, similar trends were noted after the metacarpophalangeal and tarsocrural blocks, but these increases were relatively mild and were not evident on subjective evaluation of the images. Abnormal soft tissue-phase activity was not associated with the tarsometatarsal block. On bone-phase scintigrams, increased activity was not present following any of these joint blocks.     

MECHANICAL ASPECTS OF SUBARACHNOID SPACE PUNCTURE IN THE DOG

Lumbar subarachnoid space puncture using two different techniques was performed repeatedly on a dog following injection of metrizamide into the subarachnoid space at the cervical cistern. The lumbar needle punctures were observed fluoroscopically and recorded on 100-mm spot films at a rate of 2/sec. The needle tip indented the dura, depressing it several millimeters before penetration. A hemilaminectomy was performed on a cadaver, to expose the cord and intact meninges for confirmation of this compression. Cord compression and penetration during subarachnoid space puncture may contribute to the exacerbation or aggravation of neurologic signs that sometimes follows myelography.     

COMPARISON OF TRANSPLENIC MULTIDETECTOR CT PORTOGRAPHY TO MULTIDETECTOR CT-ANGIOGRAPHY IN NORMAL DOGS

We evaluated transplenic injection of iodinated contrast medium for computed tomography (CT) assessment of the portal vasculature. Specific aims were to: (1) establish a protocol for transplenic transplenic CT portography using a 40-row multidetector scanner; (2) compare transplenic CT portography to dual-phase CT angiography in terms of image quality, opacification of the portal system, and contrast enhancement of the portal vasculature and liver; (3) compare personnel exposure during transplenic CT portography and transplenic portal scintigraphy. Seven juvenile dogs underwent transplenic portal scintigraphy, CT angiography, and transplenic CT portography. Transplenic portal scintigraphy and CT angiography were performed using previously established protocols. For transplenic CT portography, a 20- or 22 gauge needle attached to an extension set was placed into the splenic parenchyma using CT guidance. Iodinated contrast medium (175 mg I/ml) was administered, and CT acquisition was started at the time of the injection. Transplenic CT portography was simple, rapid and provided more intense enhancement of the splenic and portal veins, with a lower contrast medium dose (median dose: 525 mg I for transplenic CT portography, 7700 mg I for CT angiography), but caused inconsistent intrahepatic portal branches and parenchymal opacification due to streamlining and streak artifacts. Despite significantly lower attenuation values in the portal vein, CT angiography provided sufficient enhancement for vessel identification and more consistent parenchymal hepatic enhancement. Personnel radiation exposure rate was higher during transplenic CT portography (0.0725 mSv/min) compared with transplenic portal scintigraphy (0.000125 mSv/min). As transplenic CT portography requires an average injection time of 1 min per study; over 650 [corrected] studies must be performed before reaching the maximum permissible whole body dose of 0.05 [corrected] Sv.     

SCINTIGRAPHIC DIAGNOSIS OF INSULINOMA IN A DOG

Diagnosis of insulin-secreting tumors of the pancreas can usually be made on the basis of endocrine testing and exclusion of other causes of hyperinsulinism. In dogs, these tumors have a poor long-term prognosis due to a high rate of metastases and recurrence; staging (and therefore prognosticating) is difficult and usually done at the time of surgery. The purpose of this article is to describe a canine patient with an insulinoma, discuss the diagnostic imaging options for tumor evaluation and mention future directions for therapy. Insulinoma was suspected in an 8-year-old intact male Irish Setter. Somatostatin receptor scintigraphy using indium In-111 pentetreotide was performed and an area of increased radiopharmaceutical accumulation was found craniomedial to the right kidney. At surgery a small mass lesion in the pancreas and a larger, closely associated mass involving a mesenteric lymph node were removed. Histopathology confirmed the diagnosis of insulinoma with regional lymph node metastasis. The dog recovered from surgery and remained normal fourteen months later.     

SENSITIVITY OF RADIOGRAPHIC DETECTION OF LUNG METASTASES IN THE DOG

Thoracic radiographs were taken in right lateral recumbent (RLR), left lateral recumbent (LLR), and ventrodorsal (VD) projections in 80 dogs with known or suspected malignant tumors. Radiographs in each projection were interpreted, independently of those in the other two projections, by four veterinary radiologists, and classified as positive or negative for one or more lung metastases. The four radiologists then met, to agree on a diagnosis for each patient by simultaneously reviewing all three views. This panel diagnosis became the standard for subsequently classifying individual views as either true positive or true negative. As determined by a consensus of the panel, 25 dogs had at least one positive thoracic radiograph.
The three radiographic projections differed in sensitivity for the detection of lung metastases. In this study, the RLR view was the most sensitive, and the VD view the least sensitive. The sensitivity of detection improved significantly with multiple readers. From these data we recommend that, for detection of lung metastases in the dog, the RLR view be included in any diagnostic protocol; a minimum of two readers be used; and a three-view protocol be used if only one reader is available.     

SCINTIGRAPHIC EVALUATION OF SOLID-PHASE GASTRIC EMPTYING IN THE DOG

A technique for scintigraphically quantitating solid-phase gastric emptying in the dog was developed in a Beagle model. The test meal was determined to empty in a linear fashion, indicating a solid-phase label. The evaluation was performed on a group of dogs presented for gastrointestinal signs that were judged to have normal liquid barium sulfate fluoroscopic and radiographic studies. The results of this study indicate that this technique is valuable for identifying those patients with surgically correctable pyloric obstruction that exhibit normal gastric emptying of liquid barium.     

ULTRASONOGRAPHY OF GASTRIC ULCERATION IN THE DOG

The clinical, ultrasonographic and, when available, histopathologic findings of gastric ulceration in 7 dogs were reviewed. The most common clinical signs were vomiting, hematemesis, melena, weight loss and anemia. Ultrasonographic features of gastric ulcer included local thickening of the gastric wall, possible loss of the 5-layer structure, the presence of a wall defect or "crater", fluid accumulation in the stomach and diminished gastric motility.The localized gastric thickening varied from 9 to 16 mm. The ulcer crater was often located in the center of the thickened site and appeared as a mucosal defect associated with persistent accumulation of small echoes, most likely representing microbubbles. In this preliminary study, there was no definitive ultrasonographic distinction between benign and malignant ulcers.