Safety of percutaneous ultrasound-guided fine-needle aspiration of adrenal lesions in dogs: Perception of the procedure by radiologists and presentation of 50 cases

Background Percutaneous ultrasound (US)-guided fine-needle aspiration (FNA) of adrenal gland lesions is controversial in veterinary medicine. Objective To evaluate the frequency and radiologists' perception of the risk of the procedure as well as determining the incidence of complications. Methods Retrospective study. A first survey was submitted by e-mail to all board-certified radiologists of the American College of Veterinary Radiology (ACVR) and European College of Veterinary Diagnostic Imaging (ECVDI). A second survey was sent to radiologists who declared having performed the procedure at least once in their career (observational cross-sectional case study). Results The first survey was sent to 977 diplomates and answered by 138. Of 138 diplomates, 40 currently performed the procedure and 98 did not; 44 of the 98 gave the hypertensive crisis risk in pheochromocytoma as a reason. To the second survey, 12 of 65 responded positively; 50 dogs with 58 lesions were recruited, including 23 pheochromocytomas. Complications were reported in 4 of 50 dogs; 3 hemorrhages (1 mild and 1 moderate) and 1 death from acute respiratory distress syndrome (possibly related to laryngeal paralysis). No hypertensive crisis was reported. There was no relationship between the method of FNA/type of needle used and occurrence of complications. Based on the recollection of these 65 radiologists, who performed approximately 200 FNA of adrenal lesions, a death rate of approximately 1% was estimated. Conclusions and Clinical Importance Percutaneous US-guided FNA of adrenal lesions can be considered a minimally risky procedure, despite the negative perception by radiologists

Prediction of vascular invasion using a 7-point scale computed tomography grading system in adrenal tumors in dogs

Background: Previous studies evaluating the accuracy of computed tomography (CT) in detecting caudal vena cava (CVC) invasion by adrenal tumors (AT) used a binary system and did not evaluate for other vessels. Objective: Test a 7-point scale CT grading system for accuracy in predicting vascular invasion and for repeatability among radiologists. Build a decision tree based on CT criteria to predict tumor type. Methods: Retrospective observational cross-sectional case study. Abdominal CT studies were analyzed by 3 radiologists using a 7-point CT grading scale for vascular invasion and by 1 radiologist for CT features of AT. Animals: Dogs with AT that underwent adrenalectomy and had pre- and postcontrast CT. Results: Ninety-one dogs; 45 adrenocortical carcinomas (50%), 36 pheochromocytomas (40%), 9 adrenocortical adenomas (10%) and 1 unknown tumor. Carcinoma and pheochromocytoma differed in pre- and postcontrast attenuation, contralateral adrenal size, tumor thrombus short- and long-axis, and tumor and thrombus mineralization. A decision tree was built based on these differences. Adenoma and malignant tumors differed in contour irregularity. Probability of vascular invasion was dependent on CT grading scale, and a large equivocal zone existed between 3 and 6 scores, lowering CT accuracy to detect vascular invasion. Radiologists' agreement for detecting abnormalities (evaluated by chance-corrected weighted kappa statistics) was excellent for CVC and good to moderate for other vessels. The quality of postcontrast CT study had a negative impact on radiologists' performance and agreement. Conclusions and Clinical Importance: Features of CT may help radiologists predict AT type and provide probabilistic information on vascular invasion

Modelling Environmental Niche for the Endangered Crayfish Austropotamobius pallipesComplex in Northern and Central Italy

The potential distribution of endangered species is a necessary step to assess species conservation status and manage reintroduction plans. In the context of a EU project on the endangered Austropotamobius pallipescomplex, we modelled the environmental niche of the species in two large areas of Northern (Lombardy, 43 records) and Central Italy (Abruzzo, Province of Isernia, Gran Sasso e Monti della Laga National Park; 69 records). Ecological niche models (ENMs) were built by using the maximum entropy approach as implemented in the MaxEnt software, which predicts the occurrence of a species using presence-only data. The environmental niche was modelled using six variables: altitude, slope, aspect, human disturbance, mean temperature of warmest quarter and distance from stream. Each study area was modelled independently. Both ENMs obtained high performance scores as measured by the AUC index (Northern Italy: 0.854; Central Italy: 0.817). Slope in Northern Italy and the mean temperature of warmest quarter in Central Italy achieved the greatest predictive power. Our results clearly show that the endangered white-clawed crayfish has a narrow range of habitat selection in the two study areas. Our findings may help researchers to select the best sites for future reintroductions in conservation projects

FRI0045 CHANGES IN LEFT VENTRICULAR SYSTOLIC FUNCTION ARE PREDICTED BY DISEASE SEVERITY IN PATIENTS WITH RHEUMATOID ARTHRITISWITHOUT PRIOR CARDIOVASCULAR DISEASE

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Morphology of the toe flexor muscles in older people with toe deformities

Objective: Despite suggestions that atrophied, or weak toe flexor muscles are associated with the formation of toe deformities, there has been little evidence to support this theory. This study aimed to determine whether the size of the toe flexor muscles differed in older people with and without toe deformities. Methods: Forty-four older adults (>60 years) were recruited for the study. Each participant had their feet assessed for the presence of hallux valgus or lesser toe deformities. Intrinsic and extrinsic toe flexor muscles were imaged with an ultrasound system using a standardised protocol. Assessor blinded muscle thickness and cross-sectional area was measured using Image J software. Results: Participants with lesser toe deformities (n=20) were found to have significantly smaller quadratus plantae (p=0.003), flexor digitorum brevis (p=0.013), abductor halluces (p=0.004) and flexor halluces brevis (p=0.005) muscles than the participants without any toe deformities (n=19). Female participants with hallux valgus (n=10) were found to have significantly smaller abductor hallucis (p=0.048) and flexor halluces brevis (p=0.013) muscles than the female participants without any toe deformities (n=10; p<0.05). Conclusion: This is the first study to use ultrasound to investigate the size of the toe flexor muscles in older people with hallux valgus and lesser toe deformities compared to otherwise healthy older adults. The size of the abductor hallucis and flexor hallucis brevis muscles were decreased in participants with hallux valgus whereas the quadratus plantae, flexor digitorum brevis, abductor hallucis and flexor halluces brevis muscles were smaller in those participants with lesser toe deformities

Acromegaly in a non-diabetic cat

A 14-year-old, neutered male European shorthair cat was evaluated for a routine health check. The owner did not report any clinical signs except for respiratory stridor. On physical examination the main findings were broad facial features and increased interdental spaces. On haematology, a mild, non-regenerative anaemia was detected, whereas the serum biochemistry profile and urinalysis were unremarkable. The serum glucose concentration was within the reference interval. Serum insulin-like growth factor-1 concentration was markedly elevated (>1600 ng/ml). The basal serum growth hormone concentration was elevated and decreased only mildly after somatostatin administration. Basal serum insulin concentration was high, and the insulin concentration increased considerably after glucose loading, consistent with insulin resistance. CT scanning of the skull showed an enlarged pituitary gland and increased skull bone thickness. The final diagnosis was acromegaly

1-23I-MIBG thyroid uptake: Implications for MIBG imaging of the heart

123I-MIBG has been widely used in patients with heart failure and neurological disorders. The patients are pre-treated with Lugol's oral solution or potassium perchlorate to prevent thyroid uptake of unlabeled 123I to limit the thyroid radiation exposure. However, despite the inhibition of the iodide pump, the thyroid is frequently visualized. The aim of this study was to study the pattern of thyroid uptake

Iodine-restricted food versus pharmacological therapy in the management of feline hyperthyroidism: A controlled trial in 34 cats

Background: Hyperthyroidism is a common endocrinopathy of middle-aged and elderly cats. A dietary treatment has been proposed as alternative to traditional therapies. Aim: The aim of this prospective study was to compare the efficacy of an iodine-restricted food versus pharmacological therapy with methimazole in client-owned cats with hyperthyroidism. Methods: Indoor cats with newly diagnosed hyperthyroidism (consistent clinical signs and serum total thyroxine concentration greater than 50 nmol/L) were assigned to one of three groups: (A) received an iodine-restricted food as a single therapy; (B) received transdermal methimazole in pluronic lecithin organogel; (C) received oral methimazole. In all groups clinical parameters, biochemistry and serum total thyroxine were evaluated at baseline and 10, 30, 60, and 90 days after treatment began. Results: Thirty-four cats were enrolled in the study (group A: n=14; group B: n=11; group C: n=9). No significant differences were found between groups at diagnosis for signalment, clinical and laboratory findings, including serum total thyroxine concentrations. In all groups, serum total thyroxine concentration decreased significantly following the baseline measurement. After 90 days treatment, serum creatinine increased significantly only in the methimazole-treated groups. Liver enzyme activities decreased significantly only in group B, while no significant decreases were detected in groups A and C at any time. Conclusion: These results suggest that iodine-restricted food is effective at reducing the total thyroxine concentration in the serum of hyperthyroid cats. Moreover, the iodine-restricted food did not cause any increase of serum creatinine concentrations and failed to improve liver enzymes abnormalities. These findings could indicate a persistent hyperthyroid state in cats treated with iodine-restricted food despite normalization of serum total thyroxine concentrations

Safety of percutaneous ultrasound-guided fine-needle aspiration of adrenal lesions in dogs: Perception of the procedure by radiologists and presentation of 50 cases

Background: Percutaneous ultrasound (US)-guided fine-needle aspiration (FNA) of adrenal gland lesions is controversial in veterinary medicine. Objective: To evaluate the frequency and radiologists' perception of the risk of the procedure as well as determining the incidence of complications. Methods: Retrospective study. A first survey was submitted by e-mail to all board-certified radiologists of the American College of Veterinary Radiology (ACVR) and European College of Veterinary Diagnostic Imaging (ECVDI). A second survey was sent to radiologists who declared having performed the procedure at least once in their career (observational cross-sectional case study). Results: The first survey was sent to 977 diplomates and answered by 138. Of 138 diplomates, 40 currently performed the procedure and 98 did not; 44 of the 98 gave the hypertensive crisis risk in pheochromocytoma as a reason. To the second survey, 12 of 65 responded positively; 50 dogs with 58 lesions were recruited, including 23 pheochromocytomas. Complications were reported in 4 of 50 dogs; 3 hemorrhages (1 mild and 1 moderate) and 1 death from acute respiratory distress syndrome (possibly related to laryngeal paralysis). No hypertensive crisis was reported. There was no relationship between the method of FNA/type of needle used and occurrence of complications. Based on the recollection of these 65 radiologists, who performed approximately 200 FNA of adrenal lesions, a death rate of approximately 1% was estimated. Conclusions and Clinical Importance: Percutaneous US-guided FNA of adrenal lesions can be considered a minimally risky procedure, despite the negative perception by radiologists