Receiver operating characteristic curve analysis of the performance of various radiographic protocols when screening dogs for pulmonary metastases.

Five radiographic protocols for detecting pulmonary metastases in dogs were compared by analyzing receiver operating characteristic curves for the protocols. Protocols compared were a right lateral view only, a left lateral view only, right lateral and dorsoventral views, both lateral views, and all 3 views. Three radiologists used each of the protocols to evaluate 99 sets of thoracic radiographs. Fifty-two sets of radiographs were from dogs confirmed histologically to have pulmonary metastases and 47 were from dogs proven at necropsy to be free of pulmonary metastases. Results of the 5 protocols were not statistically different. We concluded that a third view is not necessary when routinely screening dogs with cancer for pulmonary metastases and that the standard 2-view thoracic examination should be adequate. However, in individual cases, a third view may be the determining factor in establishing a radiographic diagnosis and should be obtained if any suspicious areas are seen.