Use of Contrast-Enhanced Ultrasound in the Differential Diagnosis of Adrenal Tumors in Dogs

Abstract

We evaluated the diagnostic accuracy of the contrast-enhanced ultrasonography (CEUS), using a second-generation microbubble contrast agent, in differentiating the different types of adrenal mass lesions in 24 dogs. At B-mode ultrasound, 9 lesions involved the right adrenal gland, 14 the left, and 1 was bilateral. Each dog received a bolus of the contrast agent into the cephalic vein, immediately followed by a 5-mL saline flush. The first contrast enhancement of each adrenal lesion was evaluated qualitatively to assess the degree of enhancement and its distribution during the wash-in and wash-out phases, as well as the presence of non-vascularized areas and specific vascular patterns. Pathological diagnoses were determined in all dogs by histopathology or by cytology. Combining enhancement degree and vascularity resulted in the best predictive model, allowing CEUS to differentiate adrenocortical adenoma (n=10), adenocarcinoma (n=7), and pheochromocytoma (n=7) with an accuracy of 91.7% (P < 0.001). Combining enhancement degree and vascularity, CEUS can discriminate malignant versus benign adrenal lesions with a sensitivity of 100.0%, a specificity of 80.0%, and an accuracy of 91.7% (P < 0.001). In conclusion, results of this study confirm that CEUS is useful for differentiating between the different types of adrenal tumors in dogs.

Contrast‐enhanced ultrasound complements two‐dimensional ultrasonography in diagnosing gallbladder diseases in dogs

“…Contrast enhanced ultrasound utilizes gas‐filled microbubbles administered intravenously to obtain real‐time perfusion images of target organs and/or lesions . Recently, we used contrast‐enhanced ultrasound to diagnose gallbladder wall necrosis/rupture in dogs with a sensitivity and specificity of 100% .…”

Utility of contrast-enhanced ultrasound in differential diagnosis of adrenal tumors in dogs

“…Recent studies have reported the utility of CEUS in the diagnosis of lesions in the spleen and pancreas in dogs [20,29]. However, only a limited number of reports have described the usefulness of CEUS in the diagnosis of normal canine adrenal gland, pituitary-dependent hyperadrenocorticism, and adrenal tumors [2,[23][24][25]. In a previous study on CEUS for the diagnosis of adrenal tumors, the combination of enhancement degree and vascularity demonstrated to differentiate among CA, CAC and PHEO with an accuracy of 91.7% [2].…”

“…However, only a limited number of reports have described the usefulness of CEUS in the diagnosis of normal canine adrenal gland, pituitary-dependent hyperadrenocorticism, and adrenal tumors [2,[23][24][25]. In a previous study on CEUS for the diagnosis of adrenal tumors, the combination of enhancement degree and vascularity demonstrated to differentiate among CA, CAC and PHEO with an accuracy of 91.7% [2]. We hypothesized that CEUS is a convenient and promising technique for the differential diagnosis of canine adrenal tumors.…”

Use of Contrast-Enhanced Ultrasonography for the Characterization of Tumor Thrombi in Seven Dogs

“…Nevertheless, there is only one preliminary study in veterinary medicine comparing the use of US and/or CT for the evaluation of adrenal tumors in dogs and the detection of tissue invasion or thrombus [25]. Two studies described CEUS pattern of adrenal tumors in dogs [26,27], but a detailed description of the thrombus enhancement was not provided.…”