Is whole body CT a good idea for feline neoplasia staging?

The Diagnostic Yield of Whole‐body Computed Tomography in Dogs and Cats in the Oncology Setting

MARIA DE ALMEIDA, HUGO GREGÓRIO, ANDRÉ PEREIRA and FELISBINA L. QUEIROGA

Background
Cancer is a leading cause of morbidity and mortality in pets, prompting the need for accurate staging in veterinary oncology to inform treatment decisions and prognoses. Whole-body computed tomography (WBCT) offers a comprehensive anatomical overview, potentially improving metastasis detection over conventional imaging modalities. This study aimed to evaluate the diagnostic yield of WBCT in detecting cancer metastases in dogs and cats, particularly its ability to identify metastases outside of standard imaging regions.

Methods
This retrospective study analyzed clinical records from January 2016 to May 2023 at a veterinary hospital in Portugal. Fifty-seven animals (44 dogs and 13 cats) with histologically or cytologically confirmed primary tumors and complete medical records were included. WBCT scans were performed under general anesthesia using a standard contrast-enhanced protocol. The diagnostic yield was defined as the percentage of scans identifying metastasis. Metastatic lesions were confirmed when feasible through fine-needle aspiration or cytology.

Results
WBCT detected metastases in 20 of 57 cases (35.1% overall): 14 out of 44 dogs (31.8%) and 6 out of 13 cats (46.2%). In dogs, metastases were commonly found in the lungs, lymph nodes, liver, kidneys, muscles, and bones, including locations not typically evaluated with standard imaging. In cats, lung metastases were predominant. Notably, 24.5% of cases had altered treatment plans following WBCT findings. No adverse effects from contrast use were reported.

Limitations
Some metastases could not be confirmed histologically due to anatomical inaccessibility or procedural risk, potentially affecting diagnostic certainty. Additionally, the study lacked a direct comparison with other imaging modalities such as radiography or ultrasound, limiting assessments of WBCT’s relative effectiveness.

Conclusions
WBCT demonstrated substantial diagnostic yield and safety, enhancing metastasis detection—including in atypical locations—in both dogs and cats. These findings support WBCT’s value in oncological staging and decision-making. Broader application may improve staging accuracy and treatment planning, although cost and availability remain barriers to widespread adoption. Further research comparing WBCT with conventional imaging and its impact on prognosis and treatment is warranted.

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