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Laparoscopic Ultrasound Outperforms Traditional Imaging for Liver Lesions in Dogs
American Journal of Veterinary Research 2025
Obi Veterinary Education
November 10, 2025
Francesca P. Solari, J. Brad Case, Federico R. Vilaplana Grosso, Elizabeth A. Maxwell, Rachel W. Williams, Kathleen Ham, Roniel Cabrera
Background
Liver disease in dogs is commonly evaluated using transabdominal ultrasound (TUS) and CT, but these imaging methods have limitations in accurately detecting and localizing hepatic lesions. In human medicine, laparoscopic ultrasound (LUS) has proven superior to TUS and CT for identifying liver lesions and guiding surgical interventions. This study aimed to compare the efficacy of LUS to TUS in identifying liver lesions in dogs with clinical liver disease and to assess the utility of LUS in guiding liver biopsies.
Methods
Eight client-owned dogs with clinical liver disease were prospectively enrolled for laparoscopic liver biopsies. Each dog underwent TUS to identify and localize liver lesions, followed by laparoscopic examination and LUS. The number, size, and location of lesions detected by each imaging method were recorded, and biopsies were obtained for histopathology, copper analysis, and microbial culture.
Results
LUS identified significantly more liver lesions than TUS, with five of seven dogs having 28 additional lesions detected exclusively by LUS. The diameter of lesions identified ranged from 0.1 to 4.1 cm for LUS and 0.3 to 4.5 cm for TUS. In two cases, LUS guided the biopsy of lesions that were not visible on laparoscopic examination. No perioperative complications were reported, and all dogs were discharged within a day.
Limitations
The study's small sample size limited statistical analyses, and the lack of a gold standard diagnostic method, such as contrast-enhanced CT, prevented direct validation of lesion detection accuracy. Additionally, LUS was performed by an experienced surgeon, meaning results may vary for less experienced practitioners.
Conclusions
LUS detects more liver lesions than TUS and enables targeted biopsy of lesions that may be missed with other methods. It should be considered a valuable adjunct in staging and surgical planning for dogs with hepatic disease, particularly in cases of suspected neoplasia.
A 10-year-old male castrated Plott Hound underwent transabdominal ultrasound followed by laparoscopic liver biopsies and laparoscopic ultrasound (LUS) of the liver due to chronic liver enzyme elevations and liver nodules. A—Laparoscopic examination of the liver revealed no grossly identifiable lesions within the right medial liver lobe. The LUS transducer is applied to the midbody of the right medial liver lobe. B—Corresponding LUS image of the right medial liver lobe, revealing a well-defined, oval, hypoechoic mass measuring 1.6 cm X 0.9 cm (arrows). C—Laparoscopic examination revealed no grossly identifiable lesions within the left medial liver lobe. The LUS transducer is applied near the hilus of the left medial liver lobe. D—Corresponding LUS image of the left medial liver lobe, revealing a well-defined, hypoechoic nodule measuring 0.3 cm X 0.3 cm (arrow).
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