Many of the dogs seen on a daily basis present ‘lumps and bumps’. Possible diagnoses for these include cysts, abscesses, scar tissue, and cancer, which can be benign or malignant. Diagnosis can be either an aspirate or biopsy. HT Vista is a new device that combines heat diffusion signatures with artificial intelligence that can help us diagnose these ‘lumps and bumps’.
The learning objectives for this webinar are:
- How to approach a dog that presents with cutaneous or subcutaneous masses
- Understand the main differentials for cutaneous or subcutaneous masses
- How to perform fine needle aspirates
- Basic cytology for cutaneous or subcutaneous masses
- The rationale behind the HT Vista system
- Why the HT Vista could be useful in your clinic
Cancer is a common cause of death in dogs over the age of 10. Commonly in our basic consultations we get patients with lumps and bumps, some as small as a few mm, with others being much larger. In order to diagnose and make the best decision for our patient, Dr Dank suggests asking certain questions, including:
- How long ago was this mass first noticed?
- How much has it changed since then and has it grown?
- Has its consistency changed?
- Does the dog know it has a mass there?
- Is it in the way and does the dog scratch at it?
- Does it cause lameness?
- Has the dog had masses removed previously?
The above questions will give us a general idea of what may be going on, but it is important to continue with the physical examination, where the mass should be measured, observed and palpated.
One of the ways Dr. Dank checks masses is with the HT Vet device, the first non-invasive device that allows veterinarians to rule out cancer on the spot, in the clinic. This device does not mean that we, as physicians, do not have to make a list of differential diagnoses however, as masses can be abscesses, cysts or other.
Dr Dank, explains the importance of aspiration or taking a biopsy of any masses to know if it is malignant or benign. We can never know just by looking, so she continues the webinar with a list of advantages and disadvantages of needle aspiration and biopsy. Then, she shows the methods we can use for both techniques. It mentions how to assess the cytology, whether the sample is cellular, what type of tissue it is, whether it is a neoplasm or not and what type it is. It also mentions the criteria for malignancy. All this is explained in detail in the webinar.
Dr Dank talks about how a screening test helps doctors to detect potential health problems and diseases, what the requirements are and what value it gives us. By combining heat diffusion signals and artificial intelligence, Dr Dank feels confident that we can give an answer to our patients’ owners and not have to send our patient home without knowing whether they have cancer. The Algorithm compares the patient’s signal to learned signals and gives a probability of malignancy.
So how does this device work?
The rational physiology behind this technology is based on the tissue response to thermal excitation over a short period of time. Once heated, healthy tissue and cancerous tissue cool down at different rates, and this is what the machine measures.
In the webinar, graphs and images of different tissues and thermal pictures are shown as examples. The process takes 2 minutes and starts by identifying the mass and clipping surrounding fur. The area is then scanned, and the area of concern as well as a healthy area are marked. The results are then uploaded to the cloud and you receive a report with orange and green numbers. Orange numbers mean further investigation is recommended with green numbers showing the mass appears to be benign.
The pilot study included 45 dogs with 69 tumors (28 malignant and 41 benign) and showed an accuracy of 88% and a negative predictive value of 92%. The validation study included 525 masses of which 378 were designated as benign, 53 malignant, and 94 as non-diagnostic. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the system were 69%, 85%, 67%, 26%, and 97% respectively for all masses using the cytology and/or histopathology results as the gold standard. They propose that all lumps should be diagnosed, and newer tools may help us make better clinical decisions.
More information is detailed by Dr Dank about HT Vet and clinical cases are shown. The idea of this device is not to replace veterinarians, but to find suspicious lesions, help us decide which ones to investigate further and increase client willingness to purse diagnoses.