Episode Description
Your heart sinks when a dog’s CT shows a primary liver tumor plus extra lesions. Ours used to as well—until we dug into data showing how often those additional masses are actually benign. In this conversation with surgical oncologists Drs. Samuel Burkhardt and Hunter Piegols, we rethink what “multiple hepatic lesions” really means, and how that shift can change everything from pre-op counseling to what you sample in the OR.
We walk through their study design—primary liver tumors paired with additional lesions verified by surgical exploration and histopathology—and why imaging alone couldn’t separate benign from malignant with confidence. You’ll hear practical guidance on interpreting CT findings without leaping to metastasis, framing owner conversations to avoid a falsely negative outlook, and planning targeted biopsies that refine staging and inform follow-up. We also tackle the language problem: nodule versus mass. Without common definitions, clinicians and researchers risk misreading severity and muddying the literature. The case for cross-disciplinary standards and working groups is compelling.
Looking ahead, we explore tools that could improve preoperative decisions: contrast-enhanced ultrasound, more rigorous imaging criteria adapted from human medicine, and the promise of liquid biopsy and biomarkers to flag “bad actor” hepatocellular carcinomas. We discuss sample-size limits in veterinary studies, the value of multi-institutional collaboration, and related puzzles like what a solitary pulmonary nodule really means for prognosis. Along the way, you’ll pick up succinct surgical maxims, practical tips for histopath submission, and a reminder that small resets outside the clinic help us think clearly when cases get complex.
If this conversation helps you reframe your next liver case, share it with a colleague, subscribe for more evidence-based episodes, and leave a review so others can find the show.
JAVMA article: https://doi.org/10.2460/javma.25.07.0514
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