Objective: To compare the effect of sentinel lymph node (SLN) histology vs locoregional lymph node (LRLN) fine needle aspiration (FNA) cytology on assigned disease stage and adjunctive treatment recommendations and describe the incidence of anatomic disparity between the LRLN and SLN. Study design: A pre-post study refers to a study design type in which subjects are compared pre and post the intervention of interest. Animals: Seventeen dogs undergoing primary excision of 20 cutaneous and subcutaneous mast cell tumors (MCT). Methods: Client-owned dogs presenting to the Cornell University Hospital for Animals for surgical removal of a cytologically confirmed cutaneous or subcutaneous MCT >1 cm in diameter were enrolled. Cytological examination of FNA from the LRLN was compared with histology of the SLN. The SLN was identified by indirect computed tomographic lymphangiography (ICTL) after peritumoral injection of iopamidol and scanning at 1, 3, 5, 10, and 15 minutes. Histopathologic node score > 1 was considered metastatic. After case review by an oncologist, LRLN FNA cytology was compared with SLN histology for effect on changes in stage assignment and adjunctive treatment recommendations. Results: Mast cell tumors were graded as 2 low (n = 11), 2 high (n = 2), and subcutaneous (n = 7). Optimal scan timing was 10 minutes after injection of iopamidol. Sentinel lymph node differed anatomically from LRLN in 5 of 18 scans. Metastases were detected by histology in 9 of 20 SLN compared with in 1 of 20 FNA of LRLN (P = .001), changing stage and adjunctive treatment recommendations 8 of 20 tumors. Only 6 of 19 LRLN FNA samples were diagnostic. Conclusion: Sentinel lymph nodes were consistently identified with ICTL and differed from LRLN in one-quarter of tumors. Histopathological examination The results of this report were presented at the American College of Veterinary Surgeons annual meeting; October 16-19,

Objectives:To examine the Animal Trauma Triage (ATT) and modified Glasgow Coma Scale (mGCS) scores as predictors of mortality in injured cats. Setting: Nine Level I and II veterinary trauma centers.Animals: Consecutive sample of 711 cats reported on the Veterinary Committee on Trauma (VetCOT) case registry. Interventions: None. Measurements and Main Results:We compared the predictive power (area under receiver operating characteristic curve; AUROC) and calibration of the ATT and mGCS scores to their components. Overall mortality risk was 16.5% (95% confidence interval [CI], 13.9-19.4). Head trauma prevalence was 11.8% (n = 84). The ATT score showed a linear relationship with mortality risk.Discriminatory performance of the ATT score was excellent (AUROC = 0.87 [95% CI, 0.84-0.90]).Each ATT score increase of 1 point was associated with an increase in mortality odds of 1.78 (95% CI, 1.61-1.97, P < 0.001). The eye/muscle/integument category of the ATT showed the lowest discrimination (AUROC = 0.60). When this component, skeletal, and cardiac components were omitted from score calculation, there was no loss in discriminatory capacity compared with the full score (AUROC = 0.86 vs 0.87, respectively, P = 0.66). The mGCS showed fair performance overall for prediction of mortality, but the point estimate of performance improved when restricted to head trauma patients (AUROC = 0.75, 95% CI, 0.70-0.80 vs AUROC = 0.80, 95% CI, 0.70-0.90).The motor component of the mGCS showed the best predictive performance (AUROC = 0.71); however, the full score performed better than the motor component alone (P = 0.004). When assessment was restricted to patients with head injury (n = 84), there was no difference in performance between the ATT and mGCS scores (AUROC = 0.82 vs 0.80, P = 0.67). Conclusion:On a large, multicenter dataset of feline trauma patients, the ATT score showed excellent discrimination and calibration for predicting mortality; however, an abbreviated score calculated from the perfusion, respiratory, and neurologic categories showed equivalent performance. K E Y W O R D Sfeline, illness severity score, mortality predictor Abbreviations: ATT, Animal Trauma Triage; ATT(npr), abbreviated ATT, containing only data from the perfusion, neurologic and respiratory categories; AUROC, area under the receiver operating characteristic curve; CI, confidence interval; IQR, interquartile range; mGCS, modified Glasgow Coma Scale; SD, standard deviation.

The invasive, locally aggressive nature of feline injection‐site sarcomas (FISSs) poses a unique challenge for surgeons to obtain complete margins with surgical excision. Optical coherence tomography (OCT), an imaging technology that uses light waves to generate real‐time views of tissue architecture, provides an emerging solution to this dilemma by allowing fast, high‐resolution scanning of surgical margins. The purpose of this study was to use OCT to assess surgical margins of FISS and to evaluate the diagnostic accuracy of OCT for detecting residual cancer using six evaluators of varying experience. Five FISSs were imaged with OCT to create a training set of OCT images that were compared with histopathology. Next, 25 FISSs were imaged with OCT prior to histopathology. Six evaluators of varying experience participated in a training session on OCT imaging after which each of the evaluators was given a dataset that included OCT images and videos to score on a scale from cancerous to non‐cancerous. Diagnostic accuracy statistics were calculated. The overall sensitivity and specificity for classification of OCT images by evaluators were 78.9% and 77.6%, respectively. Correct classification rate of OCT images was associated with experience, while individual sensitivities and specificities had more variation between experience groups. This study demonstrates the ability of evaluators to correctly classify OCT images with overall low levels of experience and training and also illustrates areas where increased training can improve accuracy of evaluators in interpretation of OCT surgical margin images.

Currently, intraoperative tumour margin imaging is not routinely utilized in veterinary medicine. Optical coherence tomography (OCT) allows for real‐time assessment of tissue morphology of 1–2 mm depth. The aims of this study were (1) to compare the histologic and OCT features of excised canine skin and subcutaneous specimens, and (2) to determine the diagnostic accuracy of OCT for surgical margin evaluation. The authors hypothesized that OCT imaging would correlate well with histopathology and that OCT would be sensitive for detection of incomplete margins. Eighty dogs were prospectively enrolled. Tumours were excised, and the surgical margins were imaged using a spectral domain OCT system. The tumour type and completeness of excision were determined by histopathology. Nine blinded observers received training in OCT image interpretation and were then given a set of OCT images and videos. The observers assigned each image/video a grade from 1 (no tumour) to 4 (tumour) and the results were compared to histopathology. The overall median sensitivity and specificity of OCT imaging for detection of incomplete margins were 86.7% and 84.6%, respectively. A potential limitation is that observers had varied experience with OCT image interpretation, ranging from no prior experience to participating in a previous OCT project. OCT is sensitive for detection of incomplete margins and could be a promising real‐time surgical margin imaging modality. Further study is needed to evaluate intraoperative applications of OCT and its impact on tumour recurrence and long‐term outcome.