Evaluation of the agreement between focused assessment with sonography for trauma (AFAST/TFAST) and computed tomography in dogs and cats with recent trauma

Abstract

FAST exams reliably identify the presence of free fluid in the peritoneal and pleural cavities; however, TFAST is not a reliable method to diagnose pneumothorax in dogs and cats following trauma.

Veterinary‐focused assessment with sonography for trauma‐airway, breathing, circulation, disability and exposure: a prospective observational study in 64 canine trauma patients

“…) and is consistent with a recent study in dogs suffering from trauma that had only a moderate level of agreement between CT and TFAST for pleural effusion when performed by emergency clinicians (Walters et al . ). Alternatively, it is possible that a blood vessel was inadvertently aspirated during thoracentesis and the case did not have a true effusion.…”

Diagnosis of pulmonary contusions with point‐of‐care lung ultrasonography and thoracic radiography compared to thoracic computed tomography in dogs with motor vehicle trauma: 29 cases (2017‐2018)

“…Correct ultrasonographic identification of pneumothorax varies with ultrasonographer experience and study protocol. 17,31,32 This study primarily focused on diagnosis of PC and did not address the ability of LUS to identify pneumothorax.…”

“…Therefore, the clinician's proper identification of pneumothorax via LUS is of utmost importance as to not confuse lack of B‐ or C‐lines with normal lung. Correct ultrasonographic identification of pneumothorax varies with ultrasonographer experience and study protocol 17,31,32 . This study primarily focused on diagnosis of PC and did not address the ability of LUS to identify pneumothorax.…”

Methodological questions regarding focused assessment sonography for trauma comparison with computed tomography in dogs

“…We read with interest the publication entitled, “Evaluation of the agreement between focused assessment with sonography for trauma (AFAST/TFAST) and computed tomography (CT) in dogs and cats with trauma” by Walters et al . However, we believe the study contains design flaws and oversights in methodology, which misrepresent and underestimate the clinical utility of AFAST, TFAST, and TFAST‐detected pneumothorax.…”

“…The study's acoustic windows for AFAST are erroneously cited with incorrect format and terminology . TFAST views are also erroneous, including “cranial thorax” and omitting the diaphragmatico‐hepatic view . The TFAST protocol in the study lacked the diaphragmatico‐hepatic view for pleural effusion, the lung point (sternal/standing positioning), and imaging strategies to improve the visualization of lung sliding (centered rib head and changing angle of insonation) .…”