As a veterinarian practice owner, understanding the complexities of diagnosing dermal and...
Early detection is vital for the best outcomes in pets. Yet, more than half of dermal and subcutaneous masses in dogs go undiagnosed (1) mainly due to the cost and invasiveness of traditional tests. HT Vista, a non-invasive cancer screening tool, allows for the timely screening of dermal and subcutaneous masses, promoting early diagnosis and helping veterinarians make faster, informed decisions for early intervention.
As pet parents seek less invasive options, HT Vista offers an effective, non-invasive and affordable solution.
How Does HT Vista Work?
HT Vista’s technology is based on heat diffusion imaging. The tool heats the tissue by 42°F and detects how heat is distributed and diffused over 40 seconds. Abnormal growths often have distinct heat diffusion patterns compared to benign ones, allowing HT Vista to flag masses that may require further investigation.
What Is a Screening Tool?
In veterinary medicine, screening tools identify disease states before the patient demonstrates overt clinical signs. These tools are invaluable when screening for cancer, as early detection gives patients the best chance of effective therapy options and more time with their humans.
HT Vista fits squarely within this category. Its ability to screen masses in their early stages allows veterinarians to intervene at the most opportune moments. As a screening tool, HT Vista is a front-line tool designed not necessarily to replace aspiration or biopsy, but to complement them.
How Is HT Vista Used In Practice?
The process is simple: HT Vista is placed over and heats the mass, and its thermal diffusion patterns are analyzed. A Heat Diffusion Score between 1 and 10 is delivered in real-time and visualized in an intuitive, easy-to-understand interface. Each Heat Diffusion Score represents the probability of the mass showing benign features.
An HT Vista score between 5 and 10 has an average negative predictive value (NPV) of 98%, suggesting with confidence that the mass is likely benign. A score between 1 and 4 indicates a higher risk of cancer and that further diagnostics may be necessary.
Meanwhile, suppose a pet parent chooses to remove the mass regardless of the score or finds additional diagnostics too expensive. In that case, the veterinarian can explain that a high score allows for a more straightforward, less extensive procedure. In contrast, scores from 1 to 4 require tissue removal with wider and deeper margins.
Dermal and subcutaneous growths can originate from various tumor types (7), but HT Vista’s algorithms have been trained and are, therefore, particularly accurate when focusing on the most common.
These tumor types and respective accuracies include:
HT Vista’s Accuracy: Ongoing Improvement and New Data Since Validation
HT Vista’s initial validation studies and clinical trials (2 ,3) were performed in 2020 and 2022, respectively, demonstrating promising results.
Since then, HT Vista’s sensitivity and specificity—the ability to rule out or rule in cancer—have been enhanced through refined algorithms and advancements in machine learning (Chart 1).
Chart 1: Improvement in performance of HT Vista: Old vs. New classifiers.
HT Vista has seen significant improvements in overall performance and the conclusiveness of its results. The ideal screening tool returns results at the extremes. As shown in Figure 2, the old classifier produced a more even distribution with a slightly negative slope and fewer high (benign) scores. The newer classifier, however, shows a stronger distribution at the poles, with the majority of results now falling at either 1-2 or 9-10, offering clearer answers with more decisive results.
Figure 2: Comparing Distribution of HT Vista Heat Diffusion Scores Between Old and New Classifier
As a decision support tool, HT Vista provides clear guidance based on a probability scale. Figure 3 illustrates the prevalence of different tumor types across the score spectrum, highlighting HT Vista's strength in ruling out cancer for the most common tumors. For instance, in 118 cases with a score of 10 (highest probability of benign), no cancer was found, while in 110 cases with a score of 1 (highest risk), 88% were correctly identified as either mast cell tumors (MCT) or soft tissue sarcomas. While 13 of these were, in actuality, benign lipomas or cysts, further diagnostics ensured peace of mind when they turned out to be non-cancerous.
Another observation is that inflammatory processes can sometimes mimic the behavior of tumors with malignant features. As a result, HT Vista may detect benign cysts with inflammation across the HDI spectrum. While no screening tool is perfect, the results below highlight HT Vista's ability to guide clinicians toward better outcomes, all while reducing the invasiveness and costs associated with the incumbent diagnostic method.
Figure 3: Prevalence of Tumor Types By Heat Diffusion Score
Comparing HT Vista’s Efficacy to Human Screening Tools
To fully appreciate HT Vista’s potential, comparing it to gold-standard screening tools used in human medicine is helpful. Tools like mammography, Fecal Occult Blood Test (FOBT), and Cervical Cancer Screening (Pap smears) have revolutionized human healthcare by detecting cancer early and saving lives. Each method helps to identify specific cancers before symptoms fully manifest.
Figure 4: Comparison of HT Vista Performance vs. Human Screening Tools
HT Vista parallels these tools by offering a similarly non-invasive and highly sensitive approach. Just as mammograms screen for breast cancer in humans, HT Vista screens dermal and subcutaneous masses, aiming to flag malignancies before they pose a significant risk to the animal’s health (Figure 4).
HT Vista is on par with every performance metric of the tools used in human medicine, especially those that align with our expectations for a screening tool, all while HT Vista is on a trajectory of continuous improvement. As research and data support, HT Vista stands poised to be the mammogram equivalent in veterinary medicine—empowering veterinarians to make early, informed decisions about cancer treatment.
Conclusion
HT Vista represents a breakthrough in non-invasive cancer screening, enabling veterinarians to assess dermal and subcutaneous masses quickly, confidently and painlessly. With the technology’s ever-improving accuracy, HT Vista is rapidly becoming an indispensable tool for veterinary practices focused on early cancer detection and better treatment outcomes. By adopting HT Vista, veterinarians can provide pet
owners peace of mind from cutting-edge, compassionate care for their four-legged companions.
References
1. HT Vet Ebook
2. Dank, G., Buber, T., Polliack, G., Aviram, G., Rice, A., Yehudayoof, A., et al. (2023). A pilot study for a non-invasive system for detection of malignancy in canine subcutaneous and cutaneous masses using machine learning. Frontiers in Veterinary Science.
3. Dank, G., Buber, T., Rice, A., Kraicer, N., Hanael, E., Shasha, T., Aviram, G., et al. (2023). Training and validation of a novel non-invasive imaging system for ruling out malignancy in canine subcutaneous and cutaneous masses using machine learning in 664 masses. Frontiers in Veterinary Science.
4. Barut, M. U., Kale, A., Kuyumcuoğlu, U., Bozkurt, M., Ağaçayak, E., Özekinci, S., & Gul, T. (2015). Analysis of sensitivity, specificity, and positive and negative predictive values of smear and colposcopy in diagnosis of premalignant and malignant cervical lesions. Medical Science Monitor, 21, 3860–3867.
5. Lee, J. K., Liles, E. G., Bent, S., Levin, T. R., & Corley, D. A. (2014). Accuracy of fecal immunochemical tests for colorectal cancer: Systematic review and meta-analysis. Annals of Internal Medicine, 160(3), 171-181.
6. Liao, C.-Y., & Tyan, Y.-S. (2019). Study on Papanicolaou smear images for classification of squamous cell carcinoma. Journal of Cancer Research and Practice, 6(2), 66-71.
7. Merck Veterinary Manual. (n.d.). Tumors of the skin in dogs. Merck Veterinary Manual for Dog Owners.
