DIG X-RAY THORACIC AP VIEW
In canine thoracic radiography, the choice between two-view and three-view procedures for evaluating pulmonary metastatic disease presents a dilemma. While the latter is known for its heightened sensitivity in detecting focal lung disease, concerns arise regarding increased time, effort, and exposure for both patients and medical personnel. This study, involving 103 three-view radiographic studies of the canine thorax, aimed to compare the visibility of lesions in two-view versus three-view approaches and assess their impact on diagnostic outcomes. Four distinct protocols were reviewed for each study, categorizing radiographs as positive or negative for structured interstitial pulmonary disease. The study revealed a substantial 85-88% agreement between each two-view group and the three-view group, supported by a kapp statistic ranging from 0.698 to 0.758. Importantly, no discernible differences in diagnostic certainty emerged among the groups. However, within each group, there was a tendency for greater certainty in positive diagnoses compared to negative ones. These findings emphasize the importance of maintaining three-view studies when evaluating potential structured interstitial pulmonary diseases, including metastatic conditions, as eliminating one view could lead to diagnostic alterations in 12-15% of patients.
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