Vet360 Vet360 Vol 05 Issue 03 - Page 20

DIAGNOSTIC IMAGING Techniques for Better Radiographs By Michelle Fabiani, DVM, DACVR VETTED A radiograph can quickly become an expensive and a dangerous waste of time (think of that X-ray exposure!) if it’s not showing what is needed. Here are some tips to make you a pro. The lights in my office are off—the room dark the way I like it. The barks, meows and other various noises of our busy practice are hushed outside my closed door, which prevents interruption of my structured evaluation of each film. I search every pixel of my two black-and-white, high-definition medical-grade monitors. I’m intent on finding the cause of this patient’s breathing difficulties. Even though I will review radiographs on 25,000 patients this year, this one is exceptionally challenging. There’s an entire portion of the lung field that's all black. This area lacks information, as it is burned through. I need to see what's not possible to visualize. I don't have the needed information to obtain a diagnosis for this sick patient. I sigh. I cannot help this one this time. With the benefit of high-quality images, a teleradiologist can help obtain an accurate diagnosis and improve the well-being of patients all over the globe, including those at your practice. I've worked in both general and emergency practices. I understand you’re busy! vet360 Issue 03 | JULY 2018 | 20 Almost every veterinarian and veterinary staff member I've ever met is empathetic and caring and wants to do what is best for the pet. Most days I know it feels like you are running back and forth all day without a single second to do even one more thing. Your technician takes the radiograph of Fluffy you ask for. You look at the films and decide you want a consult. A history is necessary. The technician sees that Fluffy came in for coughing. The tech knows you’re busy and doesn't want to bother you with one more question, so the tech puts "coughing" down for history and off the consult goes. You feel a little victory and think, Great, now that the radiographs are submitted, I'll know what is going on by the end of the day! But sometimes teleradiologistis can't help with limited history such as "coughing." I like to say that general practitioners know information that is a mile wide—spanning several animal species, breeds and diseases. Conversely, I know information specific to radiology that is only an inch wide—but it’s a mile deep. As a radiologist, all I do all day, every day is imaging. All of my journal reading and continuing education meetings involve what is new in imaging. What’s the best modality to diagnose a disease? How sensitive and specific is that diagnosis? How can