Bilateral thoracic radiographs increase lesion detection in horses with pneumonia or pulmonary neoplasia but do not bring any additional benefit for inflammatory or diffuse pulmonary disease

Gwladys Malek, Mathilde Leclere, Isabelle Masseau, Alex zur Linden, Guy Beauchamp, Cyrielle Finck

Study: The study is a retrospective, single center, observational study that compares unilateral and bilateral thoracic radiographic projections for the detection of pulmonary lesions in a group of horses. The horses were classified as having pneumonia, inflammatory or diffuse pulmonary disease, and pulmonary masses based on their clinical diagnosis.

Methods: The study included 167 adults and foals with bilateral thoracic radiographs. Right-to-left and left-to-right projections were anonymized and independently interpreted by a radiologist blinded to the clinical diagnosis. Scores were attributed for each pattern/lesion and each quadrant. Agreement between scores from each projection was evaluated with Bland–Altman plots.

Results: The results showed that bilateral projections increased the probability of identifying pulmonary lesions in horses with pneumonia or neoplasia. However, in horses with inflammatory or diffuse disease, bilateral thoracic radiography provided no additional benefit.

Conclusion: The study concludes that acquiring contralateral thoracic radiographic views for horses with suspected pulmonary disease such as pneumonia or neoplasia is supported. For cases suspected of pneumonia and with financial limitations, the authors recommend adding at least one contralateral caudoventral projection since discordances were more frequent at this level for patterns seen with pneumonia. The authors did not observe additional benefit of bilateral thoracic radiographs in horses with inflammatory or diffuse pulmonary disease in their datasets.

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