title: Magnetic resonance imaging for the differentiation of neoplastic, inflammatory, and cerebrovascular brain disease in dogs.
abstract: BACKGROUND
  The reliability and validity of magnetic resonance imaging (MRI) for detecting neoplastic, inflammatory, and cerebrovascular brain lesions in dogs are unknown.
  
  
  OBJECTIVE
  To estimate sensitivity, specificity, and inter-rater agreement of MRI for classifying histologically confirmed neoplastic, inflammatory, and cerebrovascular brain disease in dogs.
  
  
  METHODS
  One hundred and twenty-one client-owned dogs diagnosed with brain disease (n = 77) or idiopathic epilepsy (n = 44).
  
  
  METHODS
  Retrospective, multi-institutional case series; 3 investigators analyzed MR images for the presence of a brain lesion with and without knowledge of case clinical data. Investigators recorded most likely etiologic category (neoplastic, inflammatory, cerebrovascular) and most likely specific disease for all brain lesions. Sensitivity, specificity, and inter-rater agreement were calculated to estimate diagnostic performance.
  
  
  RESULTS
  MRI was 94.4% sensitive (95% confidence interval [CI] = 88.7, 97.4) and 95.5% specific (95% CI = 89.9, 98.1) for detecting a brain lesion with similarly high performance for classifying neoplastic and inflammatory disease, but was only 38.9% sensitive for classifying cerebrovascular disease (95% CI = 16.1, 67.0). In general, high specificity but not sensitivity was retained for MR diagnosis of specific brain diseases. Inter-rater agreement was very good for overall detection of structural brain lesions (κ = 0.895, 95% CI = 0.792, 0.998, P < .001) and neoplastic lesions, but was only fair for cerebrovascular lesions (κ = 0.299, 95% CI = 0, 0.761, P = .21).
  
  
  CONCLUSIONS
  MRI is sensitive and specific for identifying brain lesions and classifying disease as inflammatory or neoplastic in dogs. Cerebrovascular disease in general and specific inflammatory, neoplastic, and cerebrovascular brain diseases were frequently misclassified.
authors.affiliation: Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Wolff
authors.forename: S P
authors.initials: SP
authors.lastname: Holmes
authors.forename: B D
authors.initials: BD
authors.lastname: Young
authors.forename: A V
authors.initials: AV
authors.lastname: Chen
authors.forename: M
authors.initials: M
authors.lastname: Kent
authors.forename: S R
authors.initials: SR
authors.lastname: Platt
authors.forename: M Y
authors.initials: MY
authors.lastname: Savage
authors.forename: S J
authors.initials: SJ
authors.lastname: Schatzberg
authors.forename: G T
authors.initials: GT
authors.lastname: Fosgate
authors.forename: J M
authors.initials: JM
authors.lastname: Levine
mesh_terms: D000818:Animals; D001927:Brain Diseases / Q000175:diagnosis / Q000473:pathology / Q000662:veterinary*; D003937:Diagnosis, Differential; D004283:Dog Diseases / Q000175:diagnosis* / Q000473:pathology; D004285:Dogs; D005260:Female; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000662:veterinary*; D008297:Male; D015588:Observer Variation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity