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Magnetic Resonance Imaging for the Differentiation of Neoplastic, Inflammatory, and Cerebrovascular Brain Disease in Dogs
Article first published online: 7 MAR 2012
Copyright © 2012 by the American College of Veterinary Internal Medicine
Journal of Veterinary Internal Medicine
Volume 26, Issue 3, pages 589–597, May-June 2012
Total views since publication: 70
How to Cite
Wolff, C.A., Holmes, S.P., Young, B.D., Chen, A.V., Kent, M., Platt, S.R., Savage, M.Y., Schatzberg, S.J., Fosgate, G.T. and Levine, J.M. (2012), Magnetic Resonance Imaging for the Differentiation of Neoplastic, Inflammatory, and Cerebrovascular Brain Disease in Dogs. Journal of Veterinary Internal Medicine, 26: 589–597. doi: 10.1111/j.1939-1676.2012.00899.x
Retrospective review of medical records, MRI and clinical data collection for qualifying cases, and necropsy or histopathology evaluation was performed at Texas A&M University, Washington State University, and the University of Georgia. Final review of case data submitted from each institution, database creation, and MRI processing for image analysis was performed at Texas A&M University. MR image analysis was performed at Texas A&M University and the University of Georgia. Data were analyzed at the University of Pretoria and Texas A&M University. The manuscript was written primarily at Texas A&M University.
- Issue published online: 2 MAY 2012
- Article first published online: 7 MAR 2012
- Manuscript Accepted: 24 JAN 2012
- Manuscript Revised: 22 JAN 2012
- Manuscript Received: 4 NOV 2011
The reliability and validity of magnetic resonance imaging (MRI) for detecting neoplastic, inflammatory, and cerebrovascular brain lesions in dogs are unknown.
To estimate sensitivity, specificity, and inter-rater agreement of MRI for classifying histologically confirmed neoplastic, inflammatory, and cerebrovascular brain disease in dogs.
One hundred and twenty-one client-owned dogs diagnosed with brain disease (n = 77) or idiopathic epilepsy (n = 44).
Retrospective, multi-institutional case series; 3 investigators analyzed MR images for the presence of a brain lesion with and without knowledge of case clinical data. Investigators recorded most likely etiologic category (neoplastic, inflammatory, cerebrovascular) and most likely specific disease for all brain lesions. Sensitivity, specificity, and inter-rater agreement were calculated to estimate diagnostic performance.
MRI was 94.4% sensitive (95% confidence interval [CI] = 88.7, 97.4) and 95.5% specific (95% CI = 89.9, 98.1) for detecting a brain lesion with similarly high performance for classifying neoplastic and inflammatory disease, but was only 38.9% sensitive for classifying cerebrovascular disease (95% CI = 16.1, 67.0). In general, high specificity but not sensitivity was retained for MR diagnosis of specific brain diseases. Inter-rater agreement was very good for overall detection of structural brain lesions (κ = 0.895, 95% CI = 0.792, 0.998, P < .001) and neoplastic lesions, but was only fair for cerebrovascular lesions (κ = 0.299, 95% CI = 0, 0.761, P = .21).
Conclusions and Clinical Importance
MRI is sensitive and specific for identifying brain lesions and classifying disease as inflammatory or neoplastic in dogs. Cerebrovascular disease in general and specific inflammatory, neoplastic, and cerebrovascular brain diseases were frequently misclassified.