Can Sonographic Findings Predict the Results of Liver Aspirates in Dogs With Suspected Liver Disease?

Abstract

While abdominal ultrasound and ultrasound-guided fine-needle aspiration cytology are often combined to help determine the type of liver disease in dogs, little is known about the relationship that may exist between the results of these tests. We hypothesized that specific sonographic findings, or combinations of findings, may predict results of liver ultrasound-guided fine-needle aspiration cytology. Hepatic and extrahepatic sonographic findings were recorded prospectively using a standardized form in 70 dogs with clinically suspected liver disease and in which liver ultrasound-guided fine-needle aspiration cytology was performed. The predictive value of sonographic findings in regard to the category of cytology results was assessed with stepwise logistic regression analysis. Sonographic detection of a hepatic mass ( ! 3 cm; risk ratio [RR] 3.83, 95% Wald confidence intervals [95% CI] 2.42-3.93, P ¼ 0.0036), ascites (RR 3.82, 95% CI 1.94-4.28, P ¼ 0.0044), abnormal hepatic lymph node(s) (RR 3.01, 95% CI 1.22-4.88, P ¼ 0.0262), and abnormal spleen (RR 3.26, 95% CI 1.20-3.85, P ¼ 0.0274) were the most predictive of liver neoplasia on cytology. Conversely, sonographic detection of hepatic nodules (o3 cm; RR 1.97, 95% CI 0.95-2.96, P ¼ 0.0666) was most predictive of vacuolar hepatopathy on cytology. In dogs with suspected liver disease, several sonographic findings, alone or combined, are thus predictive of liver ultrasound-guided fine-needle aspiration cytology results. In the light of the fact that ultrasound-guided fine-needle aspiration cytology of the liver has limitations, these predictabilities could influence the selection of diagnostic tests to reach a reliable diagnosis.

Analysis of clinical and ultrasonographic data by use of logistic regression models for prediction of malignant versus benign causes of ultrasonographically detected focal liver lesions in dogs

“…Another study 26 conducted to investigate the association of ultrasonographic features with liver aspirates found associations between the presence of a large hepatic mass, ascites, abnormal hepatic nodes, and splenic lesions with malignant results on cytologic examination. In the full model, the estimated logarithmic odds of a malignant disease via histologic examination was 0.28/cm, which corresponded to a 1.3-to-1 odds of malignancy for each 1-cm increase in size of an FLL.…”

“…9 Ultrasonographic features of lesions attributable to malignant and benign diseases of the liver may overlap. 16 In a more recent study, 26 it was suggested that certain ultrasonographic features may be associated with the cytologic diagnosis of liver lesions. 10 Target lesions, which consist of a focal lesion with a hyperechoic center surrounded by a hypoechoic rim, were originally considered to be strongly associated with malignancy, but they have also been found to be attributable to benign conditions.…”

Liver

“…83,84,85 Primary hepatobiliary tumors are more common than metastatic disease in cats. 83,89,93,99 Yet another study indicates no correlation of hepatocellular carcinoma with a particular echogenicity. Multifocal nodules involving several lobes, and diffuse, coalescing nodules involving all lobes are additional patterns that have been identified.…”

“…83,86 Primary liver tumors may appear as solitary masses that are confined to one lobe (Figure 9-19). 93 Mast cell tumor (MCT) infiltration into the liver does not seem to have a distinctive ultrasound appearance. Primary hepatic neoplasias are hepatocellular adenoma and carcinoma; bile duct adenoma (cystadenoma) and carcinoma Continued such as nodular hyperplasia, pyogranulomatous hepatitis, chronic active hepatitis, and cirrhosis may also produce target lesions.…”

“…Abdominal lymphadenopathy is often present (see Figure 9-24, E). 92,93 Hepatic neoplasia may appear as solitary masses that are confined to one lobe, multifocal nodules involving several lobes, or diffuse, coalescing nodules involving all lobes. 83,89,93,99 Yet another study indicates no correlation of hepatocellular carcinoma with a particular echogenicity.…”