Whole-Body Radiographs Equal Thoracic Views for Diagnosing Dog and Cat Chest Disease

Assessment of the Thorax is Equivalent When Presented with Whole-Body Versus Collimated Thoracic Radiographs in Dogs and Cats

Manabu Kurihara, Mauricio Solano, Tomoki Motegi

Background:
Traditional veterinary radiographic protocols emphasize collimation to reduce scatter and enhance image quality, particularly for thoracic imaging. However, with the improved exposure latitude and contrast resolution of digital radiography (DR) systems, whole-body radiographs (WBR) may achieve similar diagnostic quality to collimated thoracic radiographs (CTR). This study aimed to compare the diagnostic equivalence of WBR and CTR for thoracic findings in small dogs and cats.

Methods:
Forty client-owned small-breed dogs and cats presenting for respiratory or cardiovascular complaints were prospectively enrolled. Each animal underwent both WBR and CTR under sedation if needed. Six blinded reviewers (three board-certified radiologists and three general practitioners) independently evaluated 80 studies using a 12-question Likert scale survey assessing common thoracic abnormalities (e.g., cardiomegaly, pneumonia, pleural effusion). Equivalence testing and Fisher’s exact tests were performed to assess diagnostic agreement.

Results:
Diagnostic assessments were equivalent between WBR and CTR across all thoracic findings for the six reviewers overall. Minor discrepancies occurred: general practitioners (GPs) were more likely to misinterpret cardiomegaly, hypovolemia, and intrathoracic lymphadenopathy, regardless of the imaging technique. Radiologists tended to overcall esophageal dilation but without significant impact between techniques. Overall, WBR offered a practical alternative to CTR without compromising diagnostic accuracy, while reducing time and potentially lowering costs in clinical practice.

Limitations:
The study population was small and restricted to non-severely ill, small-sized animals. Breed diversity was limited, and images were obtained in an academic setting by experienced technicians, potentially limiting generalizability. Advanced imaging or pathological confirmation of diagnoses was not performed, and Likert-scale use introduced possible interpretive biases.

Conclusions:
Whole-body radiography using digital systems provides diagnostic assessments equivalent to collimated thoracic views for thoracic disease detection in dogs and cats. WBR may streamline workflow, reduce imaging time, and lower costs without compromising diagnostic confidence, though further studies across broader patient populations and disease severities are warranted.

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