GRH Radiography

Case based interactive discussion to show the role of radiotherapy for head and neck tumours. Delegates should be aware of how radiation can be used to target tumours, and the use of modern techniques such as stereotactic radiotherapy. The session also includes problems/toxicities encountered following radiotherapy, and how these are managed.

Radiology is the most widely-available imaging modality used to assess the lower respiratory tract in veterinary practice, although CT (if available) will generally give the optimal visualisation of the pulmonary structures. Interpretation of pulmonary disease on radiographs can be challenging, and obtaining images of good diagnostic quality is critical (some apparent pulmonary pathology can easily be mimicked by underexposed radiographs) – a complete radiographic examination is also important as unilateral lesions can be missed if only one radiograph is obtained. When assessing pulmonary pathology, important factors to consider are the lung pattern(s) present and their distribution – these will significantly affect the priority given to the potential differential diagnoses. The most common lung changes seen are bronchial, alveolar and nodular patterns – genuine unstructured interstitial and abnormal vascular patterns are less frequently identified. For a bronchial pattern, the most common causes are incidental age-related mineralisation and chronic bronchitis. Alveolar change (classically seen as air bronchograms) can be due to pulmonary collapse or consolidation – when consolidation is distributed ventrally (and often asymmetrically), this is more suggestive of aspiration pneumonia or haemorrhage, while bilaterally symmetric peri-hilar and caudodorsal change would be more typical of pulmonary oedema. In the UK, nodular lesions are most commonly seen with neoplastic disease.

Paul Mahoney from Idexx Teleradiology discusses radiographic positioning, including patient preparation, routine views, special techniques and alternative modalities. This one-hour webinar was first broadcast as part of BSAVA’s Learn@Lunch series. Learn@Lunch broadcasts are available to BSAVA members only and are free to attend - visit the education page of the BSAVA website for details of future Learn@Lunch webinars. Recordings will be available for 3 years via the BSAVA Webinar Library.

Radiography is an excellent tool to generate diagnostic information in cases where either a skeletal lesion or systemic disease with skeletal manifestation is suspected. The fact that radiographic equipment is available in almost all veterinary practices makes it the imaging method most often used initially to detect and characterize lesions of bones and joints. This chapter covers radiography techniques and the basics of musculoskeletal radiography.

Radiological interpretation is the process by which a radiographic study is critically evaluated and the imaging findings correlated with the clinical presentation, with the aim of advancing the management of the patient. Radiological interpretation is not easy and, although the basic principles can be taught, development of expertise requires examination of a large number of radiographs. Critical comparison of the radiological diagnosis with surgical findings, or the interpretation of the same images by an experienced radiologist, helps develop the skills required for sound radiological interpretation. Errors in radiology are common and often multi-factorial, and may involve problems with radiographic technique, evaluation of the radiograph and interpretation of any findings. Clinical audit and following up the outcome of cases, along with correlating radiological findings with other information such as surgical findings, are important in recognizing radiological errors. This chapter considers Viewing the radiograph; Routine radiographic assessment; Basic approach to radiological interpretation; Radiological report; and Errors in interpretation.

The indications for plain abdominal radiography are numerous. However, for some conditions (especially urinary and gastrointestinal disorders) contrast studies may be required to show abnormalities. The following sections are covered: Indications for radiography; Radiography; Contrast radiography; and Integration with other imaging modalities.