Risk factors and outcome in dogs with recurrent massive hepatocellular carcinoma: a Veterinary Society of Surgical Oncology case-control study

Raman spectral band imaging for the diagnostics and classification of canine and feline cutaneous tumors

This study introduces Raman imaging technique for diagnosing skin cancer in veterinary oncology patients (dogs and cats). Initially, Raman spectral bands (with specificity to certain molecular structures and functional groups) were identified in formalin-fixed samples of mast cell tumors and soft tissue sarcomas, obtained through routine veterinary biopsy submissions. Then, a custom-built Raman macro-imaging system featuring an intensified CCD camera (iXon Ultra 888, Andor, UK), tunable narrow-band Semrock (USA) optical filter compartment was used to map the spectral features at 1437 cm-1 and 1655 cm-1 in ex vivo tissue. This approach enabled wide-field (cm2), rapid (within seconds), and safe (< 400 mW/cm2) imaging conditions, supporting accurate diagnosis of tissue state. The findings indicate that machine learning classifiers - particularly support vector machine (SVM) and decision tree (DT) - effectively distinguished between soft tissue sarcoma, mastocytoma and benign tissues using Raman spectral band imaging data. Additionally, combining Raman macro-imaging with residual near-infrared (NIR) autofluorescence as a bimodal imaging technique enhanced diagnostic performance, reaching 85 - 95% in accuracy, sensitivity, specificity, and precision - even with a single spectral band (1437 cm-1 or 1655 cm-1). In conclusion, the proposed bi-modal imaging is a pioneering method for veterinary oncology science, offering to improve the diagnostic accuracy of malignant tumors.

Overactivation of Signal Transducer and Activator of Transcription 3 in Canine Hepatocellular Carcinoma and Its Prognostic Significance

Phosphorylated signal transducer and activator of transcription 3 (pSTAT3), which is related to anti-apoptosis, cellular proliferation, invasion and migration of tumours, has prognostic significance in malignant tumours in humans as well as in canine melanoma. However, the significance of pSTAT3 in canine liver tissues has not yet been evaluated. This study's objective was to compare its expression in canine normal, non-neoplastic hepatic disease and hepatocellular carcinoma (HCC) tissues by immunohistochemical analysis. Furthermore, the association between pSTAT3 immunostaining and clinicopathological factors was investigated. Overall, 68 canine liver tissues, including 10 normal liver tissues, 30 non-neoplastic hepatic disease tissues and 28 HCC tissues were examined, revealing distinct differences in pSTAT3 immunostaining among the groups. (p < 0.001). Additionally, high pSTAT3 immunostaining was significantly associated with increased tumour size (5 > cm) (p = 0.041), and metastasis (p = 0.046). Furthermore, Kaplan-Meier survival curve analysis revealed a correlation between high pSTAT3 immunostaining and poor disease-free survival (p = 0.013) and overall survival (p = 0.011). These findings suggest that overactivation of STAT3 is associated with poor prognosis in canine HCC. Therefore, pSTAT3 is considered a potential prognostic marker and therapeutic target for canine HCC.

Predictive Factors of Canine Malignant Hepatic Diseases with Multifocal Hepatic Lesions Using Clinicopathology, Ultrasonography, and Hepatobiliary Ultrasound Scores

Multifocal hepatic lesions in dogs arise from various benign and malignant liver diseases. Diagnosing these lesions is challenging because clinical signs, hematological data, and serum biochemistry are not definitive indicators. Ultrasound is utilized as a diagnostic imaging tool to evaluate liver parenchyma and detect hepatic lesions. This study aims to investigate the predictive factors that differentiate between benign and malignant multifocal hepatic lesions by examining ultrasound characteristics, blood tests, and serum biochemistry. In total, 43 dogs with multifocal hepatic lesions were included in this study. All dogs were classified into benign hepatic diseases (n = 32) and malignant haptic diseases (n = 11). For all dogs, their liver characteristics, lesion characteristics, and hepatobiliary ultrasound score by ultrasound were evaluated and we collected individual clinicopathological data for analysis. The findings of the univariate analysis revealed significant differences in four hematological and blood chemical parameters (hematocrit, white blood cell count, aspartate transaminase (AST), and alkaline phosphatase (ALP)) and six ultrasonographic parameters (liver parenchymal echogenicity, lesion homogeneity, lesion echogenicity, maximum lesion dimension, average lesion dimension, and hepatobiliary ultrasound score). Using multivariate analysis, only two parameters, hepatobiliary ultrasound score and lesion homogeneity, showed significant differences (p-value < 0.001 and p-value = 0.011, respectively). Additionally, these parameters demonstrated high accuracy in predicting malignant multifocal liver lesions, with accuracy rates of 97.67% and 93.02%, respectively. Therefore, the hepatobiliary ultrasound score and lesion homogeneity are considered effective parameters for screening malignant multifocal liver lesions in dogs.

Mitotic activity: A systematic literature review of the assessment methodology and prognostic value in canine tumors

One of the most relevant prognostic indices for tumors is cellular proliferation, which is most commonly measured by the mitotic activity in routine tumor sections. The goal of this systematic review was to analyze the methods and prognostic relevance of histologically measuring mitotic activity that have been reported for canine tumors in the literature. A total of 137 articles that correlated the mitotic activity in canine tumors with patient outcome were identified through a systematic (PubMed and Scopus) and nonsystematic (Google Scholar) literature search and eligibility screening process. Mitotic activity methods encompassed the mitotic count (MC, number of mitotic figures per tumor area) in 126 studies, presumably the MC (method not specified) in 6 studies, and the mitotic index (MI, number of mitotic figures per number of tumor cells) in 5 studies. A particularly high risk of bias was identified based on the available details of the MC methods and statistical analyses, which often did not quantify the prognostic discriminative ability of the MC and only reported P values. A significant association of the MC with survival was found in 72 of 109 (66%) studies. However, survival was evaluated by at least 3 studies in only 7 tumor types/groups, of which a prognostic relevance is apparent for mast cell tumors of the skin, cutaneous melanoma, and soft tissue tumor of the skin and subcutis. None of the studies using the MI found a prognostic relevance. This review highlights the need for more studies with standardized methods and appropriate analysis of the discriminative ability to prove the prognostic value of the MC and MI in various tumor types. Future studies are needed to evaluate the influence of the performance of individual pathologists on the appropriateness of prognostic thresholds and investigate methods to improve interobserver reproducibility.

Critical Advances for Democratizing Ultrasound Diagnostics in Human and Veterinary Medicine

The democratization of ultrasound imaging refers to the process of making ultrasound technology more accessible. Traditionally, ultrasound imaging has been predominately used in specialized medical facilities by trained professionals. Advancements in technology and changes in the health-care landscape have inspired efforts to broaden the availability of ultrasound imaging to various settings such as remote and resource-limited areas. In this review, we highlight several key factors that have contributed to the ongoing democratization of ultrasound imaging, including portable and handheld devices, recent advancements in technology, and training and education. Examples of diagnostic point-of-care ultrasound (POCUS) imaging used in emergency and critical care, gastroenterology, musculoskeletal applications, and other practices are provided for both human and veterinary medicine. Open challenges and the future of POCUS imaging are presented, including the emerging role of artificial intelligence in technology development.

Hepatic lobectomy in dogs using a stapling device with a vascular cartridge: a retrospective study of 13 cases

CASE HISTORY

Medical records of two veterinary hospitals in Canada were reviewed to identify cases of dogs that underwent liver lobectomy via open laparotomy using the Endo GIA surgical stapling device with a vascular cartridge (height of open and closed staples: 2.5 and 1.0 mm, respectively) between January 2016 and June 2018. Mean age at the time of surgery of the dogs (n = 13) included in the study was 10.4 (SD 1.5; min 7.9, max 12.8) years and mean body weight was 14 (min 3.9, max 37.8) kg.

CLINICAL FINDINGS

Liver masses requiring hepatic lobectomy were identified in 12 dogs by abdominal ultrasound examination. The remaining dog required a lobectomy of the right medial liver lobe to address leakage from the right medial lobe hepatic duct that occurred as a complication of cholecystectomy to treat a ruptured gallbladder mucocoele.

TREATMENT AND OUTCOME

Complete liver lobectomy of 14 lobes (11 from the left hepatic division) in 12 dogs and partial lobectomy of one lobe in one dog was performed via open laparotomy using the Endo GIA device. The mean surgical time, including concurrent procedures, was 50 (SD 17; median 45, min 28, max 91) minutes. The most common intra-operative complication was oozing from the transected liver parenchyma in 6/13 dogs, which was mild in all cases. Five dogs experienced minor post-operative complications. No major peri- or post-operative complications occurred, and no patients required surgical re-exploration. All patients survived until discharge and were alive at the 2-week follow-up for suture removal.

CLINICAL RELEVANCE

Use of the Endo GIA stapling device with a vascular cartridge is feasible for liver lobectomy of the left hepatic division and in this study had low rates of intra-operative and post-operative complications. The Endo GIA stapling device is a viable option for this type of liver lobectomy in dogs. Though successful, the small number of central (two lobes) and right (one lobe) hepatic division lobectomies in this study precludes us from drawing definitive conclusions about the feasibility of this technique on these divisions.

Histopathologic findings and survival outcomes of dogs undergoing liver lobectomy as treatment for spontaneous hemoabdomen secondary to a ruptured liver mass: retrospective analysis of 200 cases (2012-2020)

OBJECTIVE

To describe the distribution of histopathologic diagnoses in a large population of dogs undergoing surgical treatment for spontaneous hemoperitoneum secondary to a ruptured liver mass. Additionally, to describe survival outcomes and assess for prognostic factors for overall survival time in this population.

ANIMALS

200 client-owned dogs with spontaneous hemoperitoneum resulting from a liver mass.

PROCEDURES

Medical records from 19 veterinary referral hospitals were reviewed. Data collected included signalment, clinical signs, blood work, radiographic and ultrasonographic findings, surgical methods, intraoperative and postoperative complications, outcomes, and histopathologic findings. Follow-up information was obtained by contacting the referring veterinarian or owner.

RESULTS

Well-differentiated hepatocellular carcinoma, benign masses, hemangiosarcoma, and other malignant tumors accounted for 36% (72/200), 27.5% (55/200), 25.5% (51/200), and 11% (22/200) of cases, respectively. Overall survival time for all dogs was 356 days and for the above categories was 897 days, 905 days, 45 days, and 109 days, respectively. Prognostic factors for survival included diagnosis, increased ALT, anemia, and whether a transfusion was received. Overall survival time in dogs with increased ALT was 644 versus 63 days with normal values.

CLINICAL RELEVANCE

The majority of dogs (63.5%) were diagnosed with well-differentiated hepatocellular carcinoma or a benign process, resulting in favorable long-term survival. The distribution of histopathology for ruptured liver masses resulting in hemoperitoneum has not been previously reported and may be useful for client discussions prior to surgery.

Massive hepatoma treated with curative-intent liver lobectomy in a standard poodle dog

A 12-year-old neutered male standard poodle was seen at a veterinary clinic for a complete oral health assessment and treatment. A routine blood biochemistry revealed a marked hepatic enzymopathy, with gamma-glutamyltransferase being the most severely elevated enzyme. Liver lobectomy was performed to remove a hepatic tumor visualized on abdominal ultrasound examination. Despite concerns for a cholestatic disorder or biliary neoplasia, histopathology of the resected mass confirmed a massive hepatoma from the left lateral liver lobe.

Serum steroid profiling of hepatocellular carcinoma associated with hyperadrenocorticism in dogs: A preliminary study

Background

Hepatocellular carcinoma (HCC) is one of the most common primary liver tumors in humans and dogs. Excessive adrenocortical hormone exposure may cause steroid hepatopathy, which may develop into HCC. In our previous study, hyperadrenocorticism (HAC) was a highly concurrent disease in dogs with HCC. Therefore, this study hypothesized that adrenal steroid alterations might be involved in hepatocarcinogenesis and aimed to specify the relationship between HAC and HCC in dogs.

Materials and methods

This study included 46 dogs brought to the Hokkaido University Veterinary Teaching Hospital between March 2019 and December 2020. Owners gave their signed consent for blood collection on their first visit. A total of 19 steroids (14 steroids and 5 metabolites) in the baseline serum of 15 dogs with HCC, 15 dogs with HAC, and 10 dogs with both diseases were quantitatively measured using the developed liquid chromatography coupled with tandem mass spectrometry (LC/MS/MS) method.

Results

In each group, 11 steroids were detected higher than 50%. The detection rate of steroid hormones did not significantly differ between the groups (p > 0.05). Principle component analysis (PCA) showed that the steroid profiles of the three groups were comparable. Median steroid hormone concentrations were not significantly different between the study diseases (p > 0.05).

Conclusion

The developed LC/MS/MS was useful for measuring steroid hormones. Although it was clear that HAC was concurrent in dogs with HCC, none of the serum steroids was suggested to be involved in HCC.