Peer-reviewed veterinary case report
How accurate is CT for detecting lymph node cancer spread in dogs
By Skinner, O T et al.·Published in Veterinary and comparative oncology·2018·Department of Small Animal Clinical Sciences, United States·View original on PubMed →
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Original publication title: Diagnostic accuracy of contrast-enhanced computed tomography for assessment of mandibular and medial retropharyngeal lymph node metastasis in dogs with oral and nasal cancer.
- Species:
- dog
Plain-English summary
A group of dogs with oral and nasal cancer underwent contrast-enhanced CT scans to check for cancer spread to the lymph nodes in their necks. Out of 40 dogs, 16 had metastasis to the lymph nodes, but the CT scans were not very reliable for detecting this, showing low sensitivity rates. While the scans were good at confirming healthy lymph nodes, they missed many cases of cancer spread. Because of this, veterinarians should not rely solely on CT scans for checking lymph node metastasis in dogs with head cancers.
People also search for: dog oral cancer lymph nodes · CT scan for dog cancer · dog nasal cancer treatment
Abstract
The diagnostic accuracy of contrast-enhanced CT for detection of cervical lymph node metastasis in dogs is unknown. The purpose of this retrospective, observational, diagnostic accuracy study was to assess the efficacy of CT for detection of mandibular and medial retropharyngeal lymph node metastasis in dogs. Histopathology of dogs with cancer of the head, CT and bilateral mandibular and medial retropharyngeal lymphadenectomy was reviewed. A single radiologist measured lymph nodes to derive short axis width and long-short axis ratios. Two blinded radiologists separately assessed lymph node margins, attenuation and contrast enhancement and each provided a final subjective interpretation of each node site as benign or neoplastic. Where radiologists' opinions differed, a consensus was reached. Sensitivity, specificity and accuracy were calculated for mandibular and medial retropharyngeal sites. Agreement between radiologists was assessed. Fisher's exact test and the Kruskal-Wallis H-test were used to assess associations between variables. Forty-one primary tumours were recorded in 40 dogs. Metastasis to mandibular or retropharyngeal lymph nodes occurred in 16 out of 40 dogs (43/160 nodes). Agreement between radiologists was almost perfect for margination, attenuation and enhancement, strong for interpretation of mandibular lymph node metastasis, and weak for interpretation of medial retropharyngeal lymph node metastasis. Sensitivity of CT was 12.5% and 10.5%, specificity was 91.1% and 96.7%, and accuracy was 67.5% and 76.3% for mandibular and medial retropharyngeal lymph nodes respectively. No individual CT findings were predictive of nodal metastasis. Given the low sensitivity of CT, this modality cannot be relied upon alone for assessment of cervical lymph node metastasis in dogs.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/29989306/