{"id":33305,"date":"2023-10-17T18:01:32","date_gmt":"2023-10-17T18:01:32","guid":{"rendered":"https:\/\/todaysveterinarypractice.com\/?p=33305"},"modified":"2023-10-17T18:01:32","modified_gmt":"2023-10-17T18:01:32","slug":"effects-of-positioning-respiration-and-technique-on-interpretation-of-thoracic-radiographs-of-dogs-and-cats","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/radiology-imaging\/effects-of-positioning-respiration-and-technique-on-interpretation-of-thoracic-radiographs-of-dogs-and-cats\/","title":{"rendered":"Effects of Positioning, Respiration, and Technique on Interpretation of Thoracic Radiographs of Dogs and Cats"},"content":{"rendered":"<p><div class=\"su-note\"  style=\"border-color:#d8d8d8;border-radius:3px;-moz-border-radius:3px;-webkit-border-radius:3px;\"><div class=\"su-note-inner su-u-clearfix su-u-trim\" style=\"background-color:#f2f2f2;border-color:#ffffff;color:#333333;border-radius:3px;-moz-border-radius:3px;-webkit-border-radius:3px;\"><strong>Abstract<\/strong><\/p>\n<p class=\"p1\">Radiography in veterinary medicine is highly popular due to its low cost, ease of use, rapid image yield, and availability in most veterinary practices. Optimizing the diagnostic quality and precision of thoracic radiographic interpretation involves having properly positioned radiographs obtained on peak inspiration according to suitable radiographic technique. This article discusses the effects of patient positioning, respiration, and radiographic technique on diagnostic accuracy.<\/p>\n<p class=\"p1\"><strong>Take-Home Points<\/strong><\/p>\n<ul>\n<li class=\"p1\">Proper positioning for thoracic radiographs involves avoiding patient rotation, placing areas of interest closest to the detector plate, and centering the x-ray beam over the area of interest.<\/li>\n<li class=\"p1\">Thoracic radiographs should be taken during peak inspiration.<\/li>\n<li class=\"p1\">Sedation may be needed to reduce motion.<\/li>\n<li class=\"p1\">For thoracic radiographs, short exposure time, higher kilovoltage peak, and lower milliampere-seconds are recommended.<\/div><\/div><\/li>\n<\/ul>\n<p class=\"p1\"><span class=\"s1\">Interpretation of radiographic images is complicated by the superimposition of body parts because 3-dimensional anatomical structures are projected as 2-dimensional images.<sup>1<\/sup> Interpretation of 2-dimensional radiographs then involves recreating 3-dimensional mental images of the patient\u2019s anatomy.<sup>1,2<\/sup> Being familiar with the radiographic appearance of different organs requires a systematic and consistent approach. Having standardized views with a high level of radiographic detail is optimal for recognizing normal anatomy and lesions.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">A radiographic study of the thorax should include at least 2 orthogonal projections, including lateral and ventrodorsal\/dorsoventral projections. However, for a complete evaluation of the lungs, opposite lateral projections are also needed as inherent collapse and atelectasis within the dependent lung lobes can consequently camouflage lesions or be misinterpreted as disease, such as aspiration pneumonia or bronchopneumonia. For this reason, acquiring radiographs under sedation is preferred over general anesthesia because anesthesia can lead to atelectasis and further limit interpretation (<\/span><span class=\"s2\"><b>FIGURE 1<\/b><\/span><span class=\"s1\">).<sup>2-4<\/sup><\/span><\/p>\n<div class=\"su-image-carousel  su-image-carousel-has-spacing su-image-carousel-crop su-image-carousel-crop-4-3 su-image-carousel-has-lightbox su-image-carousel-has-outline su-image-carousel-adaptive su-image-carousel-slides-style-default su-image-carousel-controls-style-dark su-image-carousel-align-center\" style=\"max-width:70%\" data-flickity-options='{\"groupCells\":true,\"cellSelector\":\".su-image-carousel-item\",\"adaptiveHeight\":false,\"cellAlign\":\"left\",\"prevNextButtons\":true,\"pageDots\":false,\"autoPlay\":5000,\"imagesLoaded\":true,\"contain\":true,\"selectedAttraction\":0.025,\"friction\":0.28}' id=\"su_image_carousel_69d375ffa281d\"><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure1A.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 1A. Right lateral view of a dog acquired with the patient under anesthesia. With the patient under anesthesia, a mild to moderate multifocal unstructured interstitial pulmonary pattern can be seen in all lung lobes and represents atelectasis. Anesthesia can exacerbate the amount of atelectasis, resulting in border effacement of lesions, and can reduce the conspicuity of normal anatomical structures.\"><img fetchpriority=\"high\" decoding=\"async\" width=\"864\" height=\"728\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure1A.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure1A.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure1A-300x253.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure1A-768x647.png 768w\" sizes=\"(max-width: 864px) 100vw, 864px\" \/><span>Figure 1A. Right lateral view of a dog acquired with the patient under anesthesia. With the patient under anesthesia, a mild to moderate multifocal unstructured interstitial pulmonary pattern can be seen in all lung lobes and represents atelectasis. Anesthesia can exacerbate the amount of atelectasis, resulting in border effacement of lesions, and can reduce the conspicuity of normal anatomical structures.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure1B.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 1B. Right lateral view of a dog acquired the next day with the patient under sedation. The unstructured interstitial pulmonary pattern is resolved.\"><img decoding=\"async\" width=\"864\" height=\"700\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure1B.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure1B.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure1B-300x243.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure1B-768x622.png 768w\" sizes=\"(max-width: 864px) 100vw, 864px\" \/><span>Figure 1B. Right lateral view of a dog acquired the next day with the patient under sedation. The unstructured interstitial pulmonary pattern is resolved.<\/span><\/a><\/div><\/div><\/div><script id=\"su_image_carousel_69d375ffa281d_script\">if(window.SUImageCarousel){setTimeout(function() {window.SUImageCarousel.initGallery(document.getElementById(\"su_image_carousel_69d375ffa281d\"))}, 0);}var su_image_carousel_69d375ffa281d_script=document.getElementById(\"su_image_carousel_69d375ffa281d_script\");if(su_image_carousel_69d375ffa281d_script){su_image_carousel_69d375ffa281d_script.parentNode.removeChild(su_image_carousel_69d375ffa281d_script);}<\/script>\n<p class=\"p1\"><span class=\"s1\">Using a checklist will help ensure that the study is of optimal quality for interpretation (<\/span><span class=\"s2\"><b>BOX 1<\/b><\/span><span class=\"s1\">).<sup>3<\/sup> To minimize the need for retakes, the diagnostic quality of radiographs should be assessed at the time the images are acquired. At that time, special views may be elected to further help with interpretation.<\/span><\/p>\n<div class=\"su-box su-box-style-default\" id=\"\" style=\"border-color:#606060;border-radius:3px;\"><div class=\"su-box-title\" style=\"background-color:#939393;color:#FFFFFF;border-top-left-radius:1px;border-top-right-radius:1px\">BOX 1 Checklist for the Quality Control of Thoracic Radiographs<\/div><div class=\"su-box-content su-u-clearfix su-u-trim\" style=\"border-bottom-left-radius:1px;border-bottom-right-radius:1px\">\n<ul>\n<li>Is the primary beam centered on the heart? Is the patient straight?<\/li>\n<li>Are all lung margins within collimation?<\/li>\n<li>Is collimation adjusted to include only the thorax?<\/li>\n<li>Are the thoracic limbs pulled cranially away from the thoracic cavity without overstretching the patient?<\/li>\n<li>Is the patient properly oriented in relation to the plate?<\/li>\n<li>Was the radiograph acquired on peak inspiration?<\/li>\n<li>Are there any artifacts, such as motion?<\/li>\n<li>Is the radiographic exposure adequate without evidence of over- or underexposure?<\/li>\n<li>Are additional views indicated?<\/div><\/div><\/li>\n<\/ul>\n<p class=\"p1\"><span class=\"s1\">The ability to recognize or exclude lesions on radiographs depends on the radiographic accuracy of a study,<sup>1<\/sup> which requires patients being properly positioned and the radiographic technique being adequately adjusted. The primary focus of this article is the effects of positioning, respiration, and technique on thoracic radiographic interpretation.<\/span><\/p>\n<h2 class=\"p2\">Patient Positioning<\/h2>\n<p class=\"p1\"><span class=\"s1\">Radiographic interpretation is based on viewing images in a similar manner every time so that abnormalities are more easily recognized and on evaluating radiographs acquired with a standardized positioning protocol.<\/span><\/p>\n<h3 class=\"p3\">Viewing<\/h3>\n<p class=\"p1\"><span class=\"s1\">When radiographs are viewed, image interpretation depends on established standard display protocols. The cranial or right side of the patient should always be on the viewer\u2019s left,<sup>5<\/sup> which requires appropriate positioning of the patient across the length of the imaging plate. Although it may be tempting to position larger patients diagonally across the imaging plate to reduce the number of radiographs needed, doing so renders interpretation more difficult (<\/span><span class=\"s2\"><b>FIGURE 2<\/b><\/span><span class=\"s1\">); therefore, acquiring multiple projections of the cranial and caudal aspect of the thorax is preferred.<\/span><\/p>\n<div class=\"su-image-carousel  su-image-carousel-has-spacing su-image-carousel-crop su-image-carousel-crop-4-3 su-image-carousel-has-lightbox su-image-carousel-has-outline su-image-carousel-adaptive su-image-carousel-slides-style-default su-image-carousel-controls-style-dark su-image-carousel-align-center\" style=\"max-width:70%\" data-flickity-options='{\"groupCells\":true,\"cellSelector\":\".su-image-carousel-item\",\"adaptiveHeight\":false,\"cellAlign\":\"left\",\"prevNextButtons\":true,\"pageDots\":false,\"autoPlay\":5000,\"imagesLoaded\":true,\"contain\":true,\"selectedAttraction\":0.025,\"friction\":0.28}' id=\"su_image_carousel_69d375ffa2f05\"><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure2A.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 2A. Right lateral radiograph of a cat diagonally positioned in relation to the detector plate, hindering the ability to view the obtained images using standard hanging protocols.\"><img decoding=\"async\" width=\"864\" height=\"809\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure2A.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure2A.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure2A-300x281.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure2A-768x719.png 768w\" sizes=\"(max-width: 864px) 100vw, 864px\" \/><span>Figure 2A. Right lateral radiograph of a cat diagonally positioned in relation to the detector plate, hindering the ability to view the obtained images using standard hanging protocols.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure2B.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 2B. Ventrodorsal radiograph of a cat diagonally positioned in relation to the detector plate, hindering the ability to view the obtained images using standard hanging protocols.\"><img loading=\"lazy\" decoding=\"async\" width=\"864\" height=\"780\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure2B.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure2B.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure2B-300x271.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure2B-768x693.png 768w\" sizes=\"(max-width: 864px) 100vw, 864px\" \/><span>Figure 2B. Ventrodorsal radiograph of a cat diagonally positioned in relation to the detector plate, hindering the ability to view the obtained images using standard hanging protocols.<\/span><\/a><\/div><\/div><\/div><script id=\"su_image_carousel_69d375ffa2f05_script\">if(window.SUImageCarousel){setTimeout(function() {window.SUImageCarousel.initGallery(document.getElementById(\"su_image_carousel_69d375ffa2f05\"))}, 0);}var su_image_carousel_69d375ffa2f05_script=document.getElementById(\"su_image_carousel_69d375ffa2f05_script\");if(su_image_carousel_69d375ffa2f05_script){su_image_carousel_69d375ffa2f05_script.parentNode.removeChild(su_image_carousel_69d375ffa2f05_script);}<\/script>\n<h3 class=\"p3\">Positioning<\/h3>\n<p class=\"p4\"><b>Patient Alignment<\/b><\/p>\n<p class=\"p1\"><span class=\"s1\">Rotating the patient results in a nonstandardized projection of anatomical structures with less familiar superimposition of the anatomy, which can create confusion and result in lesions being missed or overinterpreted. Therefore, the patient must be properly aligned as even small degrees of obliquity can alter the appearance of the cardiac silhouette and other intrathoracic structures. On ventrodorsal views, right or left rotation of the thorax can result in a mediastinal shift and lead to the false impression of cardiac chamber enlargement or dilation of the great vessels (<\/span><span class=\"s2\"><b>FIGURE 3<\/b><\/span><span class=\"s1\">). Similarly, on lateral views, rotation of the thorax can also lead to misinterpretation as cardiomegaly and may affect vertebral heart score measurements.<\/span><\/p>\n<div id=\"attachment_33310\" style=\"width: 360px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure3.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-33310\" class=\"wp-image-33310\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure3.png\" alt=\"\" width=\"350\" height=\"413\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure3.png 860w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure3-254x300.png 254w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure3-768x906.png 768w\" sizes=\"(max-width: 350px) 100vw, 350px\" \/><\/a><p id=\"caption-attachment-33310\" class=\"wp-caption-text\">Figure 3. Ventrodorsal radiograph with mild leftward rotation of the thorax. There is subsequent artifactual rounding of the right cardiac margin (arrowheads) with a bulge at the 1\u20132 o\u2019clock position in the region of the main pulmonary artery (asterisk), which may be falsely interpreted as main pulmonary artery enlargement and right-sided cardiomegaly, as seen with pulmonary hypertension.<\/p><\/div>\n<p class=\"p1\"><span class=\"s1\">When patients are positioned for thoracic radiographs, cranial extension of the thoracic limbs is necessary to reduce superimposition of the appendicular musculature over the cranial aspect of the thoracic cavity.<sup>3,4<\/sup> With increased muscle mass over the cranial thorax, particularly on lateral projections, soft tissue opacity will appear increased and can be confused with cranial mediastinal disease or can mask pulmonary disease (<\/span><span class=\"s2\"><b>FIGURE 4<\/b><\/span><span class=\"s1\">).<sup>3,4<\/sup> In addition, caudal retraction of the thoracic limbs with or without hunching of the patient will cause the sternum to deviate dorsally and can be falsely interpreted as pectus excavatum (<\/span><span class=\"s2\"><b>FIGURE\u00a05<\/b><\/span><span class=\"s1\">). Also to be avoided is excessive cranial extension of the thoracic limbs as it can result in distortion of the thoracic anatomy.<\/span><\/p>\n<div class=\"su-image-carousel  su-image-carousel-has-spacing su-image-carousel-crop su-image-carousel-crop-4-3 su-image-carousel-has-lightbox su-image-carousel-has-outline su-image-carousel-adaptive su-image-carousel-slides-style-default su-image-carousel-controls-style-dark su-image-carousel-align-center\" style=\"max-width:70%\" data-flickity-options='{\"groupCells\":true,\"cellSelector\":\".su-image-carousel-item\",\"adaptiveHeight\":false,\"cellAlign\":\"left\",\"prevNextButtons\":true,\"pageDots\":false,\"autoPlay\":5000,\"imagesLoaded\":true,\"contain\":true,\"selectedAttraction\":0.025,\"friction\":0.28}' id=\"su_image_carousel_69d375ffa3653\"><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure4A.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 4A. Right lateral radiograph of dog, acquired with the limbs  mildly caudally retracted\"><img loading=\"lazy\" decoding=\"async\" width=\"864\" height=\"720\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure4A.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure4A.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure4A-300x250.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure4A-768x640.png 768w\" sizes=\"(max-width: 864px) 100vw, 864px\" \/><span>Figure 4A. Right lateral radiograph of dog, acquired with the limbs  mildly caudally retracted<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure4B.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 4B. Right lateral radiograph of dog, acquired with the limbs cranially extended. Cranial extension of the thoracic limbs reduces superimposition of the appendicular musculature over the cranial thoracic region, increasing the conspicuity of a cranioventral mediastinal mass.\"><img loading=\"lazy\" decoding=\"async\" width=\"864\" height=\"618\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure4B.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure4B.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure4B-300x215.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure4B-768x549.png 768w\" sizes=\"(max-width: 864px) 100vw, 864px\" \/><span>Figure 4B. Right lateral radiograph of dog, acquired with the limbs cranially extended. Cranial extension of the thoracic limbs reduces superimposition of the appendicular musculature over the cranial thoracic region, increasing the conspicuity of a cranioventral mediastinal mass.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure5.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 5. Right lateral radiograph of a cat with caudally retracted thoracic limbs and subsequent dorsal deviation of the sternum cranially (arrowheads), not to be misinterpreted as pectus excavatum.\"><img loading=\"lazy\" decoding=\"async\" width=\"852\" height=\"1019\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure5.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure5.png 852w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure5-251x300.png 251w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure5-768x919.png 768w\" sizes=\"(max-width: 852px) 100vw, 852px\" \/><span>Figure 5. Right lateral radiograph of a cat with caudally retracted thoracic limbs and subsequent dorsal deviation of the sternum cranially (arrowheads), not to be misinterpreted as pectus excavatum.<\/span><\/a><\/div><\/div><\/div><script id=\"su_image_carousel_69d375ffa3653_script\">if(window.SUImageCarousel){setTimeout(function() {window.SUImageCarousel.initGallery(document.getElementById(\"su_image_carousel_69d375ffa3653\"))}, 0);}var su_image_carousel_69d375ffa3653_script=document.getElementById(\"su_image_carousel_69d375ffa3653_script\");if(su_image_carousel_69d375ffa3653_script){su_image_carousel_69d375ffa3653_script.parentNode.removeChild(su_image_carousel_69d375ffa3653_script);}<\/script>\n<p class=\"p1\"><span class=\"s1\">The patient\u2019s neck should be positioned in a neutral to slightly stretched cranial position as ventroflexion can result in dorsal deviation of the trachea within the cranial thoracic region on lateral views (<\/span><span class=\"s2\"><b>FIGURE 6<\/b><\/span><span class=\"s1\">), with possibly more pronounced focal rightward deviation of the trachea on a ventrodorsal\/dorsoventral view, which can mimic a mass effect, as occasionally seen with cardiac neoplasms.<sup>4,5<\/sup><\/span><\/p>\n<div class=\"su-image-carousel  su-image-carousel-has-spacing su-image-carousel-crop su-image-carousel-crop-4-3 su-image-carousel-has-lightbox su-image-carousel-has-outline su-image-carousel-adaptive su-image-carousel-slides-style-default su-image-carousel-controls-style-dark su-image-carousel-align-center\" style=\"max-width:70%\" data-flickity-options='{\"groupCells\":true,\"cellSelector\":\".su-image-carousel-item\",\"adaptiveHeight\":false,\"cellAlign\":\"left\",\"prevNextButtons\":true,\"pageDots\":false,\"autoPlay\":5000,\"imagesLoaded\":true,\"contain\":true,\"selectedAttraction\":0.025,\"friction\":0.28}' id=\"su_image_carousel_69d375ffa3c71\"><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure6A.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 6A. Lateral radiograph of a dog with a ventrally flexed neck and consequent dorsal deviation of the trachea within the cranial thoracic region (arrowhead).\"><img loading=\"lazy\" decoding=\"async\" width=\"773\" height=\"609\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure6A.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure6A.png 773w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure6A-300x236.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure6A-768x605.png 768w\" sizes=\"(max-width: 773px) 100vw, 773px\" \/><span>Figure 6A. Lateral radiograph of a dog with a ventrally flexed neck and consequent dorsal deviation of the trachea within the cranial thoracic region (arrowhead).<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure6B.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 6B. In another lateral radiograph of the same dog with a straightened neck, the tracheal deviation is resolved.\"><img loading=\"lazy\" decoding=\"async\" width=\"864\" height=\"699\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure6B.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure6B.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure6B-300x243.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure6B-768x621.png 768w\" sizes=\"(max-width: 864px) 100vw, 864px\" \/><span>Figure 6B. In another lateral radiograph of the same dog with a straightened neck, the tracheal deviation is resolved.<\/span><\/a><\/div><\/div><\/div><script id=\"su_image_carousel_69d375ffa3c71_script\">if(window.SUImageCarousel){setTimeout(function() {window.SUImageCarousel.initGallery(document.getElementById(\"su_image_carousel_69d375ffa3c71\"))}, 0);}var su_image_carousel_69d375ffa3c71_script=document.getElementById(\"su_image_carousel_69d375ffa3c71_script\");if(su_image_carousel_69d375ffa3c71_script){su_image_carousel_69d375ffa3c71_script.parentNode.removeChild(su_image_carousel_69d375ffa3c71_script);}<\/script>\n<p class=\"p4\"><b>Magnification<\/b><\/p>\n<p class=\"p1\"><span class=\"s1\">Because x-rays produced by the generator travel in a straight path from a single source, the structures that will first interact with x-rays (farthest from the detector plate) will be magnified in relation to structures that are closer to the detector plate.<sup>2,5<\/sup> Therefore, lesions can be more accurately measured when they are placed closer to the detectors. Similar positioning is also helpful for projecting lesions in a comparable manner when obtaining recheck radiographs at different times.<\/span><\/p>\n<p class=\"p4\"><b>Geometric Distortion<\/b><\/p>\n<p class=\"p1\"><span class=\"s1\">Emitted x-rays diverge from the source and interact with tissues outside of their direct path from the generator to the detector plates.<sup>2<\/sup> The entire imaging plate within the set collimation is subsequently exposed; however, because the incoming x-rays interact with tissues of the shortest path between the generator and detector plate, some degree of geometric distortion is expected and is more pronounced peripherally. Therefore, anatomical structures at the outer periphery of the field of view should be cautiously interpreted.<sup>2<\/sup> This concept also emphasizes the value of centering the x-ray beam over the cardiac silhouette for a more accurate interpretation of cardiovascular structures.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Radiography of the vertebral column is best achieved by acquiring several collimated projections centered on multiple vertebral segments. As a result, the area of the vertebral column centered within the field of view will be more accurately represented, especially with regard to intervertebral disk space widths.<sup>3,5<\/sup> Because of the divergent nature of the x-rays, the intervertebral disk spaces that are in the periphery of the image will be artifactually narrowed (<\/span><span class=\"s2\"><b>FIGURE 7<\/b><\/span><span class=\"s1\">).<sup>2,5<\/sup><\/span><\/p>\n<div class=\"su-image-carousel  su-image-carousel-has-spacing su-image-carousel-crop su-image-carousel-crop-16-9 su-image-carousel-has-lightbox su-image-carousel-has-outline su-image-carousel-adaptive su-image-carousel-slides-style-default su-image-carousel-controls-style-dark su-image-carousel-align-center\" style=\"max-width:70%\" data-flickity-options='{\"groupCells\":true,\"cellSelector\":\".su-image-carousel-item\",\"adaptiveHeight\":false,\"cellAlign\":\"left\",\"prevNextButtons\":true,\"pageDots\":false,\"autoPlay\":5000,\"imagesLoaded\":true,\"contain\":true,\"selectedAttraction\":0.025,\"friction\":0.28}' id=\"su_image_carousel_69d375ffa42a8\"><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure7A.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 7. Divergence of the x-ray beam from the main source will cause intervertebral disk spaces that are off-centered to be artifactually narrowed. (A) The T11\u2013T12 intervertebral disk space is artifactually narrowed due to tangential projection of the x-rays (arrowhead).\"><img loading=\"lazy\" decoding=\"async\" width=\"863\" height=\"287\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure7A.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure7A.png 863w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure7A-300x100.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure7A-768x255.png 768w\" sizes=\"(max-width: 863px) 100vw, 863px\" \/><span>Figure 7. Divergence of the x-ray beam from the main source will cause intervertebral disk spaces that are off-centered to be artifactually narrowed. (A) The T11\u2013T12 intervertebral disk space is artifactually narrowed due to tangential projection of the x-rays (arrowhead).<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure7B.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 7B. Centering the x-ray source over the T11\u2013T12 intervertebral disk space will result in a more accurate projection of the intervertebral disk space width and resolution of the previously noted narrowing (arrowhead).\"><img loading=\"lazy\" decoding=\"async\" width=\"861\" height=\"282\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure7B.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure7B.png 861w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure7B-300x98.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure7B-768x252.png 768w\" sizes=\"(max-width: 861px) 100vw, 861px\" \/><span>Figure 7B. Centering the x-ray source over the T11\u2013T12 intervertebral disk space will result in a more accurate projection of the intervertebral disk space width and resolution of the previously noted narrowing (arrowhead).<\/span><\/a><\/div><\/div><\/div><script id=\"su_image_carousel_69d375ffa42a8_script\">if(window.SUImageCarousel){setTimeout(function() {window.SUImageCarousel.initGallery(document.getElementById(\"su_image_carousel_69d375ffa42a8\"))}, 0);}var su_image_carousel_69d375ffa42a8_script=document.getElementById(\"su_image_carousel_69d375ffa42a8_script\");if(su_image_carousel_69d375ffa42a8_script){su_image_carousel_69d375ffa42a8_script.parentNode.removeChild(su_image_carousel_69d375ffa42a8_script);}<\/script>\n<h2 class=\"p2\">Effects of Respiration<\/h2>\n<p class=\"p1\"><span class=\"s1\">Motion will result in blurred images.<sup>2<\/sup> The subsequent loss of image detail can hide disease or create artifacts that mimic disease. In some instances, <\/span>anatomical structures may be completely unrecognizable.<span class=\"s1\"> With thoracic radiography, motion usually results from patient movement or respiration. Therefore, proper <\/span>immobilization of patients with sedation and positioning<span class=\"s1\"> devices will minimize degradation of image quality.<sup>4<\/sup><\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Acquiring thoracic radiographs during peak inspiration is essential for optimal aeration of the lungs and avoiding effacement of lesions by atelectasis,<sup>2<\/sup> which can be falsely interpreted as disease. Obtaining radiographs during peak inspiration is also essential for separating intrathoracic structures, removing superimposition, and facilitating interpretation. The reduced superimposition during inspiration may be particularly apparent when assessing the triangular arrangement between the caudal margin of the cardiac silhouette, diaphragm, and caudal vena cava because greater separation and improved conspicuity of these structures will be noted.<sup>4<\/sup> In addition, reduced intrathoracic volume on expiration can result in kinking of the trachea within the cranial thoracic region (<\/span><span class=\"s2\"><b>FIGURE 8<\/b><\/span><span class=\"s1\">).<\/span><\/p>\n<div id=\"attachment_33318\" style=\"width: 363px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure8.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-33318\" class=\"wp-image-33318\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure8.png\" alt=\"\" width=\"353\" height=\"277\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure8.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure8-300x236.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure8-768x604.png 768w\" sizes=\"(max-width: 353px) 100vw, 353px\" \/><\/a><p id=\"caption-attachment-33318\" class=\"wp-caption-text\">Figure 8. Ventrodorsal radiograph of a dog, acquired during the patient\u2019s expiration. With reduced pulmonary volume, bunching of the intrathoracic structures may cause kinking of the trachea within the cranial thoracic region and should not be misinterpreted as a pathological mass effect.<\/p><\/div>\n<p class=\"p1\"><span class=\"s1\">The decreased intrathoracic volume during expiration can result in the false impression of cardiomegaly as the cardiac silhouette will occupy a greater portion of the thoracic cavity (<\/span><span class=\"s2\"><b>FIGURE 9<\/b><\/span><span class=\"s1\">), thus making measurements of cardiac silhouette to thoracic width less reliable. In addition, Olive et al noted variation in vertebral heart score measurements during peak inspiration and expiration; larger measurements were obtained during expiration.<sup>6<\/sup> Therefore, consistent acquisition of thoracic radiographs will reduce variability, improve the accuracy of measurements, and optimize pulmonary contrast to aid with disease recognition.<sup>2,6<\/sup><\/span><\/p>\n<div class=\"su-image-carousel  su-image-carousel-has-spacing su-image-carousel-crop su-image-carousel-crop-4-3 su-image-carousel-has-lightbox su-image-carousel-has-outline su-image-carousel-adaptive su-image-carousel-slides-style-default su-image-carousel-controls-style-dark su-image-carousel-align-center\" style=\"max-width:70%\" data-flickity-options='{\"groupCells\":true,\"cellSelector\":\".su-image-carousel-item\",\"adaptiveHeight\":false,\"cellAlign\":\"left\",\"prevNextButtons\":true,\"pageDots\":false,\"autoPlay\":5000,\"imagesLoaded\":true,\"contain\":true,\"selectedAttraction\":0.025,\"friction\":0.28}' id=\"su_image_carousel_69d375ffa48c2\"><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure9A.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 9A. Ventrodorsal radiograph of a dog, acquired during the patient\u2019s expiration. With reduced pulmonary volume during expiration, the cardiac silhouette occupies a larger portion of the thoracic cavity and may be falsely interpreted as cardiomegaly.\"><img loading=\"lazy\" decoding=\"async\" width=\"864\" height=\"818\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure9A.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure9A.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure9A-300x284.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure9A-768x727.png 768w\" sizes=\"(max-width: 864px) 100vw, 864px\" \/><span>Figure 9A. Ventrodorsal radiograph of a dog, acquired during the patient\u2019s expiration. With reduced pulmonary volume during expiration, the cardiac silhouette occupies a larger portion of the thoracic cavity and may be falsely interpreted as cardiomegaly.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure9B.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 9B. Ventrodorsal radiograph of a dog, acquired during the patient\u2019s inspiration.\"><img loading=\"lazy\" decoding=\"async\" width=\"864\" height=\"959\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure9B.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure9B.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure9B-270x300.png 270w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure9B-768x852.png 768w\" sizes=\"(max-width: 864px) 100vw, 864px\" \/><span>Figure 9B. Ventrodorsal radiograph of a dog, acquired during the patient\u2019s inspiration.<\/span><\/a><\/div><\/div><\/div><script id=\"su_image_carousel_69d375ffa48c2_script\">if(window.SUImageCarousel){setTimeout(function() {window.SUImageCarousel.initGallery(document.getElementById(\"su_image_carousel_69d375ffa48c2\"))}, 0);}var su_image_carousel_69d375ffa48c2_script=document.getElementById(\"su_image_carousel_69d375ffa48c2_script\");if(su_image_carousel_69d375ffa48c2_script){su_image_carousel_69d375ffa48c2_script.parentNode.removeChild(su_image_carousel_69d375ffa48c2_script);}<\/script>\n<h2 class=\"p2\">Radiographic Technique<\/h2>\n<p class=\"p1\"><span class=\"s1\">When thoracic radiographs are acquired, respiration and cardiac motions are inherent. Motion can reduce the sharpness of intrathoracic structures, rendering them less well defined and more difficult to assess. For this reason, when the thorax is radiographed, exposure time should be adjusted.<sup>2<\/sup> A short exposure time is preferred. Technique using high kilovoltage peak (kVp) and low milliampere-seconds (mAs) is advised, taking into consideration the patient\u2019s size and body condition. Using a technique chart is advised to decrease the probability of having to repeat radiographs if overexposed or underexposed.<sup>7<\/sup><\/span><\/p>\n<h3 class=\"p3\">Overexposure<\/h3>\n<p class=\"p1\"><span class=\"s1\">Given the inherent high contrast of the thorax, the radiographic technique should be carefully adjusted to not overpenetrate regions of lesser density, such as the lungs. Radiographs that are overexposed will be diffusely darkened with complete blackening and loss of detail in regions of lower tissue density (<\/span><span class=\"s2\"><b>FIGURE\u00a010A<\/b><\/span><span class=\"s1\">).<sup>2,4,7<\/sup> The anatomy in affected regions will be inconspicuous, which in some cases may be falsely interpreted as pneumothorax. Therefore, recognizing this artifact will help avoid misdiagnosis.<\/span><\/p>\n<div class=\"su-image-carousel  su-image-carousel-has-spacing su-image-carousel-crop su-image-carousel-crop-4-3 su-image-carousel-has-lightbox su-image-carousel-has-outline su-image-carousel-adaptive su-image-carousel-slides-style-default su-image-carousel-controls-style-dark su-image-carousel-align-center\" style=\"max-width:70%\" data-flickity-options='{\"groupCells\":true,\"cellSelector\":\".su-image-carousel-item\",\"adaptiveHeight\":false,\"cellAlign\":\"left\",\"prevNextButtons\":true,\"pageDots\":false,\"autoPlay\":5000,\"imagesLoaded\":true,\"contain\":true,\"selectedAttraction\":0.025,\"friction\":0.28}' id=\"su_image_carousel_69d375ffa4ead\"><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure10A.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 10A. Right lateral radiograph of a dog, showing saturation artifacts within the cranial thoracic region resulting from overexposure.\"><img loading=\"lazy\" decoding=\"async\" width=\"864\" height=\"688\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure10A.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure10A.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure10A-300x239.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure10A-768x612.png 768w\" sizes=\"(max-width: 864px) 100vw, 864px\" \/><span>Figure 10A. Right lateral radiograph of a dog, showing saturation artifacts within the cranial thoracic region resulting from overexposure.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure10B.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 10B. Right lateral radiograph of a dog, showing appropriate radiographic technique.\"><img loading=\"lazy\" decoding=\"async\" width=\"864\" height=\"764\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure10B.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure10B.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure10B-300x265.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure10B-768x679.png 768w\" sizes=\"(max-width: 864px) 100vw, 864px\" \/><span>Figure 10B. Right lateral radiograph of a dog, showing appropriate radiographic technique.<\/span><\/a><\/div><\/div><\/div><script id=\"su_image_carousel_69d375ffa4ead_script\">if(window.SUImageCarousel){setTimeout(function() {window.SUImageCarousel.initGallery(document.getElementById(\"su_image_carousel_69d375ffa4ead\"))}, 0);}var su_image_carousel_69d375ffa4ead_script=document.getElementById(\"su_image_carousel_69d375ffa4ead_script\");if(su_image_carousel_69d375ffa4ead_script){su_image_carousel_69d375ffa4ead_script.parentNode.removeChild(su_image_carousel_69d375ffa4ead_script);}<\/script>\n<h3 class=\"p3\">Underexposure<\/h3>\n<p class=\"p1\"><span class=\"s1\">Radiographs that are underpenetrated do not have adequate contrast and will have generalized whitening of the image (<\/span><span class=\"s2\"><b>FIGURE 10C<\/b><\/span><span class=\"s1\">).<sup>2,4,7<\/sup> Thoracic structures and lesions may subsequently be inconspicuous, especially in overconditioned or larger patients.<sup>2,4,7<\/sup> When mAs are set too low, a smaller number of electrons will be created and, therefore, fewer x-rays will be projected through the patient, resulting in a grainy image (i.e., quantum mottling) (<\/span><span class=\"s2\"><b>FIGURE 11<\/b><\/span><span class=\"s1\">).<sup>8<\/sup><\/span><\/p>\n<div class=\"su-image-carousel  su-image-carousel-has-spacing su-image-carousel-crop su-image-carousel-crop-4-3 su-image-carousel-has-lightbox su-image-carousel-has-outline su-image-carousel-adaptive su-image-carousel-slides-style-default su-image-carousel-controls-style-dark su-image-carousel-align-center\" style=\"max-width:70%\" data-flickity-options='{\"groupCells\":true,\"cellSelector\":\".su-image-carousel-item\",\"adaptiveHeight\":false,\"cellAlign\":\"left\",\"prevNextButtons\":true,\"pageDots\":false,\"autoPlay\":5000,\"imagesLoaded\":true,\"contain\":true,\"selectedAttraction\":0.025,\"friction\":0.28}' id=\"su_image_carousel_69d375ffa54bb\"><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure10C.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 10C. Right lateral radiograph of a dog, showing underexposure with reduced pulmonary contrast.\"><img loading=\"lazy\" decoding=\"async\" width=\"864\" height=\"809\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure10C.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure10C.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure10C-300x281.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure10C-768x719.png 768w\" sizes=\"(max-width: 864px) 100vw, 864px\" \/><span>Figure 10C. Right lateral radiograph of a dog, showing underexposure with reduced pulmonary contrast.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure11.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 11. Right lateral radiograph of a dog, showing a grainy appearance resulting from radiographic underexposure (i.e., quantum mottle).\"><img loading=\"lazy\" decoding=\"async\" width=\"864\" height=\"757\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure11.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure11.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure11-300x263.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2023\/10\/Huguet_TVPNovDec23_ThoracicRadiographTechnique_Figure11-768x673.png 768w\" sizes=\"(max-width: 864px) 100vw, 864px\" \/><span>Figure 11. Right lateral radiograph of a dog, showing a grainy appearance resulting from radiographic underexposure (i.e., quantum mottle).<\/span><\/a><\/div><\/div><\/div><script id=\"su_image_carousel_69d375ffa54bb_script\">if(window.SUImageCarousel){setTimeout(function() {window.SUImageCarousel.initGallery(document.getElementById(\"su_image_carousel_69d375ffa54bb\"))}, 0);}var su_image_carousel_69d375ffa54bb_script=document.getElementById(\"su_image_carousel_69d375ffa54bb_script\");if(su_image_carousel_69d375ffa54bb_script){su_image_carousel_69d375ffa54bb_script.parentNode.removeChild(su_image_carousel_69d375ffa54bb_script);}<\/script>\n<h2 class=\"p2\">Summary<\/h2>\n<p class=\"p1\"><span class=\"s1\">Radiography is a valuable diagnostic tool used routinely in veterinary practices for disease identification. The positioning of patients and timing\/settings used for image acquisition are crucial for acquiring high-quality radiographs and enhancing recognition of lesions. Using a methodological approach will increase efficacy by reducing the number of retake radiographs and is well worth the extra time to more accurately interpret radiographs and to guide further diagnostic and treatment recommendations. <\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The positioning of patients and timing\/settings used for image acquisition are crucial for acquiring high-quality radiographs and enhancing recognition of lesions.<\/p>\n","protected":false},"author":236,"featured_media":33325,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":4642,"footnotes":""},"categories":[426],"tags":[13],"class_list":["post-33305","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-november-december-2023","tag-peer-reviewed","column-insights-in-imaging","clinical_topics-radiology-imaging"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.7 (Yoast SEO v27.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Effects of Positioning, Respiration, and Technique on Interpretation of Thoracic Radiographs of Dogs and Cats | Today&#039;s Veterinary Practice<\/title>\n<meta name=\"description\" content=\"The positioning of patients and timing\/settings are crucial 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