PET-CT confirms no recurrence of canine liver cancer

Conventional imaging techniques, such as CT, provide excellent anatomical detail, they may not always determine whether tissue changes represent active cancer, inflammation, or chronic benign disease. PET-CT combines metabolic and anatomical imaging, allowing veterinarians to assess the biological activity of lesions throughout the body in a single scan.

In this case, the primary goals of imaging were to determine whether the previously excised hepatocellular carcinoma had recurred, assess for metastatic spread, and investigate the patient’s neurological, urinary, and orthopaedic abnormalities.

The patient underwent whole-body PET-CT imaging using the radiotracer F18-fluorodeoxyglucose (F18-FDG), administered intravenously at a dose of 167 MBq. Imaging acquisition commenced approximately 60 minutes following tracer administration.

Physiological tracer uptake was observed in expected regions, including the brain, salivary glands, myocardium, abdominal organs, gastrointestinal tract, and urinary system, confirming appropriate scan quality and distribution.

Importantly, PET-CT demonstrated no evidence of recurrence of the previously excised hepatocellular carcinoma. Small hepatic nodules identified on CT imaging showed no increased FDG uptake, strongly supporting benign chronic liver changes rather than active malignancy.

There was also no evidence of recurrent chylothorax, metastatic pulmonary disease, or intrathoracic lymph node involvement. Small mineralised pulmonary foci detected throughout the lungs were considered most consistent with benign mineralised osteomas.

Outside the liver, PET-CT identified several clinically relevant but non-neoplastic abnormalities. The urinary bladder wall demonstrated asymmetrical thickening, most consistent with chronic cystitis. Mild pancreatic thickening without significant FDG avidity suggested previous pancreatitis rather than active pancreatic disease.

The scan also highlighted widespread musculoskeletal and spinal abnormalities contributing to the patient’s clinical presentation. Moderate degenerative joint disease was identified within the right stifle, alongside milder degenerative changes affecting the left stifle, left elbow, and left shoulder. PET-CT additionally demonstrated inflammatory uptake affecting the left hind paw, most consistent with pododermatitis and associated reactive lymph node enlargement.

Neurologically, chronic intervertebral disc disease was detected, including disc protrusion at T2-T3, causing mild spinal cord compression. Mild uptake associated with cervical nerve roots raised the possibility of neuritis, although these findings were considered less likely to represent neoplasia.

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