Red Bank Veterinary Hospital reports two PET/CT cases that drove opposite clinical decisions

According to a clinical review published in Veterinary Practice News, "approximately one in four dogs will develop cancer during their lifetime," a figure that makes earlier detection valuable. Dr. Peter Chapman, medical director at Red Bank Veterinary Hospital in Tinton Falls, New Jersey, wrote the review.

That figure makes earlier detection valuable, but whether finding disease before symptoms appear changes what a veterinarian can do for the patient is harder to answer. Two recent cases at Red Bank show how the same imaging technology can drive opposite decisions, one prompting intervention, the other supporting watchful waiting, and both hinge on clinical judgment, not the scan alone.

The subcutaneous lesion found on an unrelated scan

One dog underwent PET/CT imaging for an unrelated reason. The scan identified a small, previously unrecognized subcutaneous lesion. Excisional biopsy confirmed it was a mast cell tumor. Detecting it before progression or clinical signs allowed the veterinary team to provide what Chapman described as "timely, likely curative treatment."

A second dog presented with an atypical cystic liver lesion. PET/CT was used "to help characterize the mass," Chapman wrote. "The absence of radiopharmaceutical uptake suggested" low likelihood of "aggressive disease, allowing the patient to avoid a high-risk liver biopsy and surgery," according to the article. "The lesion has remained stable on subsequent ultrasound examinations, supporting" the decision not to intervene.

In one case, technology prompted action. In the other, it supported doing nothing. The imaging provided information; the veterinarian made the call.

What PET/CT measures and what it leaves out

PET/CT combines two modalities. CT provides detailed anatomical imaging, helping clinicians identify "the location, size, and characteristics of an abnormality," Chapman wrote. "PET detects metabolic activity through a radiopharmaceutical tracer." Together, according to the article, "veterinarians can examine both the structure of an abnormality and its biological activity."

The technology is "best known for its role in oncology, where it may help detect lesions and stage disease," Chapman wrote. "There are also indications in other fields, such as investigating" fever of unknown origin or unexplained lameness.

But "an imaging finding alone will rarely be specific enough to establish a diagnosis without additional testing," Chapman wrote. "Incidental findings may sometimes lead to unnecessary diagnostic tests." Chapman argued that whether the information will meaningfully change what a veterinarian does for the patient matters more than what the technology can show.

The AI layer and what it does not replace

AI is already being used in veterinary practice "for diagnostic support, medical documentation, client communication, and administrative tasks," Chapman noted. "When these tools reduce the time clinicians spend organizing information or completing records, they can create more time for patients and their owners."

"Like advanced imaging, however, AI provides information and assistance, not final answers," Chapman wrote. "Its outputs may be incomplete, biased, or incorrect, and veterinary professionals must evaluate them within the complete clinical picture." According to the article, "practices also need clear policies for data privacy, appropriate use, human oversight, and verification."

"A 2026 study of 673 veterinary workers found that although 72.3 percent believed AI would change the profession, 90.5 percent reported receiving little or no formal AI training," Chapman wrote. "Technology may change how veterinarians work," but according to Chapman, "clinical judgment, accountability, and communication must remain firmly in human hands."

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The questions to ask before recommending an advanced diagnostic

Before recommending an advanced diagnostic test, Chapman suggested veterinary teams consider several questions. The source article listed them as part of helping "veterinarians and clients determine the most appropriate care based on medical, emotional, ethical, and financial considerations," though the specific questions themselves were not detailed in the text.

"Every patient is different, and every family has unique goals and circumstances regarding their pets," Chapman wrote. "Two pets may have the same diagnosis, yet the plan for each may differ because of factors such as age, temperament, anticipated quality of life, and treatment burden."

"Better diagnostics enable more informed treatment plans, and veterinary teams can help clients understand which option is best for them," according to the article. "This is an important part of providing a complete spectrum of care." Chapman argued that "the most technologically advanced option is not always the best one. Technology should support shared decision-making, not dictate it."

Our read

The one-in-four cancer incidence figure makes early detection sound like an obvious win, but the Red Bank cases show the real work starts after the scan. Finding a subcutaneous mast cell tumor before it causes symptoms is a clear win when excision is curative. Finding a cystic liver lesion that would require high-risk biopsy to confirm is a win only if you can defend not biopsying it, and that defense rests on metabolic imaging plus serial monitoring, not on the scan alone.

The gap Chapman is naming is the one between what a test can detect and what a veterinarian should do about it. PET/CT expands the former; clinical judgment still owns the latter. The 90.5 percent of veterinary workers reporting little or no formal AI training suggests most practices are adopting tools faster than they are training teams to interpret them, which moves liability from the technology vendor to the clinician.

For the associate two years out, this means you are the one explaining to a client why finding cancer early may not mean treating it early, with no decision tree to follow. For the owner-DVM, adopting advanced imaging means training your team on how to present uncertain findings and managing client expectations when technology outpaces evidence, or losing referrals to practices that do. We're watching whether the protocols for interpreting these scans arrive before the liability cases do.

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