September 26, 2025 • 15 mins
Ever wondered what we might be missing with traditional imaging techniques? Dr. Francesca Solari's groundbreaking research reveals a game-changing approach to diagnosing liver disease in dogs.
Laparoscopic ultrasonography is transforming how veterinarians evaluate canine liver disease, detecting lesions that traditional methods miss. Dr. Solari takes us through a fascinating AJVR study showing how this minimally invasive technique identifies more liver nodules than conventional transabdominal ultrasound. Perhaps most surprising? All lesions biopsied during her research turned out to be benign – a crucial reminder that finding nodules doesn't automatically indicate metastatic disease.
"Nothing is actually idiopathic," Dr. Solari notes provocatively. "It just means that we've missed the diagnosis." This philosophy drives the research into advanced diagnostic techniques that provide veterinarians with more complete information before determining treatment plans. Dr. Solari envisions a future where laparoscopic ultrasound becomes standard practice before curative-intent surgery, guiding decisions about surgical approaches, microwave ablation, or alternative therapies.
This episode highlights the beautiful translational relationship between human and veterinary medicine, with innovations flowing in both directions. Dr. Solari's work exemplifies how raising the standard of care in veterinary medicine ultimately benefits our beloved animal companions through more precise, personalized treatment plans. Whether you're a veterinary professional or simply passionate about advances in animal healthcare, this conversation offers valuable insights into the future of veterinary diagnostics.
Listen, subscribe, and share your thoughts on this episode! Your ratings and reviews help us continue bringing you cutting-edge veterinary research that changes practice.
AJVR article: https://doi.org/10.2460/ajvr.25.01.0031
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Green East Death Foods (00:00):
From the makers of that recommended
Green East Death Foods comes toeasy weight to support your fast
devil tests.
Green East Smart Central DriedFood Divers and Free Found
Nutrition with Diasback Recipes.
Green East Delphin.
Developed by a team of PhDanimal nutritionists.
Offers options to help supporthealthy joints, digestion, and
(00:23):
more.
Whether it's mealtime ormobility support.
Green Eats helps you care foryour dog from the inside out.
Learn more at greeneats.com.
Sarah Wright (00:35):
This is Veterinary Vertex, a podcast to the AVMA
Journals.
In this episode, we chat abouthow laparoscopic ultrasonography
identifies more liver lesionsin dogs compared to
transabdominal ultrasonographywith our guest, Francesca
Solari.
Lisa Fortier (00:52):
Welcome, listeners.
I'm editor-in-chief LisaFortier, and I'm joined by
Associate Editor Sarah Wright.
Today we have Francesca joiningus to talk about laparoscopic
ultrasonography.
I'm really excited to learnabout this from you, Francesca.
So thanks so much for takingtime to be with us here today.
Sarah Wright (01:07):
Yeah, thank you so much for having me.
All right, let's dive right in.
So, Francesca, your AJBRarticle discusses how
laparoscopic ultrasoundidentifies more liver lesions
compared to transabdominalultrasound and can be used to
guide the biopsy of lesions thatare not grossly appreciable
laparoscopically.
Please share with our listenersthe background on this article.
Francesca Solari (01:27):
In our veterinary patients, uh staging
of liver cancer is hugelyimportant in the management of
these cases and very critical toensure that we're providing the
best quantity of life, but alsoquality of life for our
patients.
And the modalities that we havefor staging of cancer and liver
cancer and specifically havedrastically improved over the
(01:50):
last couple of decades.
We're very lucky to have, youknow, CT, contrast enhanced CT,
you know, things like that arehands, but even those modalities
with their improvements havebeen shown to fall short in
several studies.
And we miss liver lesions or weincorrectly localize them.
(02:10):
And that can definitely alterthe treatment recommendations
and the prognosis for thosepatients.
And so in human medicine, theyuse laparoscopic ultrasound and
staging of liver cancer.
And it's been shown to resultin better accuracy and picking
up lesions more often thanthings like contrasting against
(02:30):
MRI, CT.
So that's kind of what drove meto look at this in dogs.
And what are some of theimportant take-home messages
from this AJBR article?
I think importantly, you know,is that we have all of these
different modalities.
And this paper isn't to saythat we should only be using
laparoscopic ultrasound andstaging of liver cancer, but
(02:52):
instead it's just one more kindof tool at our fingertips to use
in these patients.
So still doing pre-operative,you know, trans abdominal
ultrasound or CT to stage andevaluate these patients, but
then going that extra step aswell to use laparoscopic
ultrasound and make sure we'renot missing anything on those
(03:13):
preoperative imaging modalities.
So I think that's the biggesttakeaway for me.
And as we're seeing kind ofthis increase in the number of
pet owners who are wanting to,you know, raise the standard of
care for their animals.
And we're starting to kind ofsee, you know, more minimally
invasive surgery options in ourveterinary patients.
(03:33):
And we're really kind ofraising the bar of what we're
doing in veterinary medicine,just realizing that we have, you
know, more and more things tomake sure that we're optimizing
our patient outcomes.
Lisa Fortier (03:43):
Yeah, what I my big take home, Francesca, from
this with uh atopical is get thediagnosis right.
Like, you know, people like,oh, I tried that and it didn't
work.
I'm like, did you have thediagnosis or were you just
shotgunning?
And that's that's fine to startthere.
But if you really want to honedown and, like you said, make a
precise patient-oriented uhspecific treatment, then you
(04:06):
need to get it right.
Francesca Solari (04:08):
Yeah, absolutely.
And it's actually not relatedto this paper, but one of my
biggest pet peeves is the termidiopathic, because to me,
nothing is actually idiopathic.
It just means that we've missedthe diagnosis.
Lisa Fortier (04:20):
Fair.
Good point.
Um what sparked your researchinterest in this?
Was there a specific case ordid you read about it in human
literature?
What, what, what drove you tostart investigating this in
veterinary medicine?
Francesca Solari (04:33):
Yeah, well, I've been really lucky here at
UF, where I did my residency,um, that I've worked with some
fantastic mentors, both in lifeand in surgery and also in
research.
Um, and I've worked primarilyhere with Dr.
Brad Cast, who's one of oursurgeons and also very big in
the minimally invasive surgeryworld.
Um, and he had done some workwith microwave ablation of liver
(04:56):
tumors.
Um, and one of the challengeswith microwave ablation uh is
the you need to make sure thatyou're getting um coagulation of
the entire tumor and you'reusing a little pinpoint uh
needle to stick it in the tumor.
And if you're not in the idealspot or you don't do multiple
ablation zones, you're not goingto get complete necrosis or
(05:19):
coagulative necrosis of thattumor.
Um, and so one of the thingsthat kind of sparked the
interest in using laparoscopicultrasound of the liver was
using it to optimize microwaveablation and even microwave
ablation minimally invasively.
So doing it through alaparoscopic approach.
Um, so that's really kind ofwhat started it.
And then diving onto the humanside.
And I think honestly, for a lotof the research in veterinary
(05:41):
medicine, we are so lucky tohave our human counterparts to
look to and kind of help guideour research in what directions
we go next.
Um, but there's just so muchwork looking at laparoscopic
ultrasound on the human side andhow it can maximize patient
outcomes for minimally invasivesurgery and not just for the
liver, for other kind ofindications as well.
Um, and that just reallyspiraled into a couple of my
(06:04):
research projects that I've doneover the years.
Lisa Fortier (06:07):
That's fantastic.
Yeah, I think in veterinarymedicine, it's really, you know,
we inform human medicine too.
So it's really a nicetranslational one health
approach.
Yeah.
Sarah asked you earlier whatwere some of the take-home
messages, but always when we dostudies like this, there's
something that surprises us andthen gets us to do another
study.
So what surprised you from thisarticle?
Francesca Solari (06:28):
Yeah, I mean, um, not a lot surprising in the
sense that I was anticipating wewere probably going to find
more lesions with thelaparoscopic ultrasound, and um
it was going to be moresensitive just because we have
our human kind of counterpartpapers to look to, and that's
what they've found.
But I think the one kind offinding of the study that isn't
really a major finding, um, butthat interested me or surprised
(06:50):
me is that all of the lesionsthat we biopsied were benign.
Um, and you know, to somedegree, that's probably patient
selection and that thesepatients were largely presenting
for, you know, chronic liverenzyme elevations, et cetera.
But almost all of our patientshad liver nodules.
And I think that that's just animportant reminder that as we
(07:10):
get more and more diagnosticsthat, you know, give us more
information and maybe we findmore nodules, even in a patient
that has liver cancer, we needto be cognizant of the fact
that, you know, it doesn'tnecessarily mean they have
metastatic disease.
Um, and so, you know, part ofum the concept behind
laparoscopic ultrasound as astaging tool is that it should
(07:31):
be paired with biopsies and notjust kind of used to condemn the
patient and say they havemetastatic disease without
further evaluation.
Lisa Fortier (07:39):
Yeah, I mean, this isn't cancer, but in the, I'm
an equine orthopedic surgeon onour side of the of the gate.
People are doing ultrasoundexams of, for example, tendons
and ligaments uh on pre-purchaseexams, and they're they're
incidental findings, right?
But the horses that use yourword condemned, and it's like
put it together with a wholefunction.
(08:00):
It's not it's not just animaging test.
Francesca Solari (08:03):
Yeah, absolutely.
I think it's it's this catch22, right?
Because um, as we develop moreand we become more advanced in
veterinary medicine, we get morediagnostics that give us more
information.
It's really important toremember, A, you know, remember
that we need to interpret it inlight of the patient and
correlate with our clinicalfindings.
Um, but also, you know,remember why we're doing our
(08:26):
diagnostics and why they'reindicated and not just kind of
throw a patient in the CT um,you know, because you're gonna
find incidental findings.
Sarah Wright (08:34):
Exactly.
Choosing diagnostics based onwhat the result, if that's gonna
change your plan of action,basically.
So yeah, I even challenge myown like cats veterinarians
sometimes when I bring them in.
I'm like, okay, so you want todo this chemistry plan.
Well, what are we gonna find onthat?
It's gonna change our course ofaction, or are we just doing it
to do it?
So yeah, exactly.
So what are the next steps toresearch then for you?
Francesca Solari (08:52):
Yeah, I mean, I think that um this, you know,
what are where I would like tosee this go is similar to the
way that they do it on the humanside is, you know, the patients
go through their preoperativestaging.
So they go through their CT,they go through their, you know,
transabdominal ultrasounddepending on, you know, what you
choose to do.
Um, and then before going toany kind of curative intent
(09:13):
surgery, they undergolaparoscopic biopsies with
laparoscopic ultrasound.
Because I think not only doesthat get us more information, we
may find additional nodules, weget biopsy samples to know what
the primary tumor is, but alsoto know if there's any evidence
of metastatic disease.
And then it could also evenguide, you know, our surgical
plan.
So we can evaluate the tumorlaparoscopically, get an idea
(09:37):
of, you know, is this actuallysurgically resectable?
Or is this something where weneed to be considering a
different type of therapy likechemoembolization or radiation
therapy?
Uh, is this something we canlaparoscopically remove?
Um, so do like a laparoscopicliver resection.
Or if we find that there'sdiffuse disease, then do we
consider something likemicrowave ablation?
(09:59):
Um, and so really optimizingthe specific treatment plan for
each patient without just goingin and doing a full exploratory
laparotomy and finding out thatmaybe we can't even surgically
resect that tumor, or maybe itwasn't the best option for that
patient specifically.
Sarah Wright (10:15):
Do you see a role in for AI in this area of
research?
Francesca Solari (10:18):
Yeah, I mean, it's I think there's so much
room for AI in veterinarymedicine, and we're already
starting to see that transition.
Um, for this specifically, Ithink there could be a role, and
I guess we'll see how AI kindof comes into diagnostic imaging
over the next decade or so.
Um, but I think there coulddefinitely be a role in trying
to pick up those liver nodules,you know, on the ultrasound,
(10:41):
because one of the challengesthat we faced in this um study
was, you know, you're looking atthe laparoscopic image on the
screen.
Um so you're watching thevideo, but you're also trying to
look at the ultrasound monitorseparately.
And so you're having to kind ofgo back and forth between the
two.
And so even though we picked upmore nodules, we may have
missed, you know, potentiallysome um liver lesions or liver
(11:03):
nodules.
Lisa Fortier (11:04):
Yeah, really good point.
Uh you spoke earlier about thegreat mentorship that you have
received and lots of differentaspects of uh life and
profession.
How did your training and allthat mentorship prepare you to
write this article?
Francesca Solari (11:19):
I think um in a couple of different ways.
Uh, I've been very lucky uhhere at UF where we have a
master's degree program.
Um, and so you know, ourresidency is a little bit
longer, but it really affords usthe opportunity to get involved
in prospective clinical trialsbecause as I'm sure you know,
those take time.
Um, they take a lot of energy.
(11:39):
Um, but I think that they giveus very valuable information.
And I think there's a time andplace for retrospectives, but
also, you know, we need both umprospective and retrospective
studies.
So being here and having thatmaster's degree and having that
extra time to do a clinicaltrial has really helps me with,
you know, doing this research.
Um, but also just havingmentors here who are constantly
(12:02):
willing to try new things andpush the envelope a little bit.
Um and then being across thestreet from Shans, UF Shans,
which is the human hospital, um,and having people who, you
know, that one health approach,like we mentioned, where we can
um chat with them about how theymanage their patients.
If we're trying something newfor the first time, they can
come over and help us.
(12:22):
Um, so I think that all ofthose things together have made
it so that I can, you know, dothis type of research, which I
feel very lucky.
Sarah Wright (12:30):
Well, we love hearing that.
So, Francesca, you share a lotof really valuable information
today with us.
And now we're gonna ask yousomething really hard to do.
You can boil it down to onepiece of information, like
veterinarians are gonna go see aclient, they're gonna be
talking about this.
What is one thing they need toshare with them?
So, Francesca, what is onepiece of information the
veterinarian should know aboutlaparoscopic ultrasound for
(12:51):
evaluation of the liver in dogswith clinical liver disease?
Francesca Solari (12:55):
I think for me, just knowing that it's an
available option.
And so, you know, when aveterinarian is faced with one
of these patients that eitherhas uh, you know, elevated liver
enzymes or, you know, has aliver tumor, um, realizing that
referral for that kind of goldstandard of care, um, getting
more information or getting themost information we can before
(13:17):
we dive into any kind oftreatment is out there.
Um, and so just being aware ofthat.
Sarah Wright (13:22):
And on the other side of the relationship, that's
one thing that clients shouldknow about this.
Francesca Solari (13:26):
I think on the same note, um, just knowing
that there are um, you know,options available for people and
they can um, you know, havethat further information about
their pet and they can um, youknow, think about the best
treatment option for their petbefore they have to dive into
anything.
I think having more informationfor owners helps give them
(13:49):
peace of mind.
Um, so I think that to me isreally the most valuable aspect
for clients.
Lisa Fortier (13:54):
Yeah, one of my favorite sayings is knowledge is
powered.
Absolutely.
Uh Francesca, thanks so much.
This is really fascinating.
I didn't know about this untilI read your article.
So thank you for sharing itwith Jabma.
Yeah, of course.
As we wind down a little bit,we like to ask just a more fun
question.
So for you, I would like toknow what is your favorite
(14:15):
animal fact?
Francesca Solari (14:17):
Um, well, I'm a big fan of otters.
I love otters.
And um, I recently found outthat otters like to juggle and
they also like to save rocksthat are their favorite rocks,
and they keep it in their littlebelly pouch.
Lisa Fortier (14:30):
So I did not know that.
We we've heard that they sleep,I don't remember what it's
called.
They sleep holding hands sothat they they're what's it
called?
Sarah Wright (14:40):
Rats.
Lisa Fortier (14:41):
Rats.
Francesca Solari (14:43):
Yeah, they're fascinating creatures.
They're not the nicest though,actually, to people.
Sarah Wright (14:49):
Yeah, Francesca, I came to the AVMA from the
Vancouver Aquarium.
We had quite the robust otterpopulation there.
So they definitely keep you onyour toes, that is for sure.
They like to save their littlerocks too, and sometimes they'll
try to use it to like excavateout of their exhibits.
So always keep you in close eyeat them.
They're very smart.
Well, thank you so much,Francesca, for being here today
(15:10):
and for also sharing your workwith AJVR.
We appreciate it.
Of course.
Thank you so much, guys.
I really appreciate it.
And to our listeners, you canread Francesca's article on
AJVR.
I'm Sarah Wright with LisaFortier.
Be on the lookout for nextweek's episode, and don't forget
to leave us a rating and reviewon Apple Podcasts or whatever
platform you listen to.
From the makers of that recommended
Green East Death Foods comes toeasy weight to support your fast
devil tests.
Green East Smart Central DriedFood Divers and Free Found
Nutrition with Diasback Recipes.
Green East Delphin.
Developed by a team of PhDanimal nutritionists.
Offers options to help supporthealthy joints, digestion, and
(00:23):
more.
Whether it's mealtime ormobility support.
Green Eats helps you care foryour dog from the inside out.
Learn more at greeneats.com.
Sarah Wright (00:35):
This is Veterinary Vertex, a podcast to the AVMA
Journals.
In this episode, we chat abouthow laparoscopic ultrasonography
identifies more liver lesionsin dogs compared to
transabdominal ultrasonographywith our guest, Francesca
Solari.
Lisa Fortier (00:52):
Welcome, listeners.
I'm editor-in-chief LisaFortier, and I'm joined by
Associate Editor Sarah Wright.
Today we have Francesca joiningus to talk about laparoscopic
ultrasonography.
I'm really excited to learnabout this from you, Francesca.
So thanks so much for takingtime to be with us here today.
Sarah Wright (01:07):
Yeah, thank you so much for having me.
All right, let's dive right in.
So, Francesca, your AJBRarticle discusses how
laparoscopic ultrasoundidentifies more liver lesions
compared to transabdominalultrasound and can be used to
guide the biopsy of lesions thatare not grossly appreciable
laparoscopically.
Please share with our listenersthe background on this article.
Francesca Solari (01:27):
In our veterinary patients, uh staging
of liver cancer is hugelyimportant in the management of
these cases and very critical toensure that we're providing the
best quantity of life, but alsoquality of life for our
patients.
And the modalities that we havefor staging of cancer and liver
cancer and specifically havedrastically improved over the
(01:50):
last couple of decades.
We're very lucky to have, youknow, CT, contrast enhanced CT,
you know, things like that arehands, but even those modalities
with their improvements havebeen shown to fall short in
several studies.
And we miss liver lesions or weincorrectly localize them.
(02:10):
And that can definitely alterthe treatment recommendations
and the prognosis for thosepatients.
And so in human medicine, theyuse laparoscopic ultrasound and
staging of liver cancer.
And it's been shown to resultin better accuracy and picking
up lesions more often thanthings like contrasting against
(02:30):
MRI, CT.
So that's kind of what drove meto look at this in dogs.
And what are some of theimportant take-home messages
from this AJBR article?
I think importantly, you know,is that we have all of these
different modalities.
And this paper isn't to saythat we should only be using
laparoscopic ultrasound andstaging of liver cancer, but
(02:52):
instead it's just one more kindof tool at our fingertips to use
in these patients.
So still doing pre-operative,you know, trans abdominal
ultrasound or CT to stage andevaluate these patients, but
then going that extra step aswell to use laparoscopic
ultrasound and make sure we'renot missing anything on those
(03:13):
preoperative imaging modalities.
So I think that's the biggesttakeaway for me.
And as we're seeing kind ofthis increase in the number of
pet owners who are wanting to,you know, raise the standard of
care for their animals.
And we're starting to kind ofsee, you know, more minimally
invasive surgery options in ourveterinary patients.
(03:33):
And we're really kind ofraising the bar of what we're
doing in veterinary medicine,just realizing that we have, you
know, more and more things tomake sure that we're optimizing
our patient outcomes.
Lisa Fortier (03:43):
Yeah, what I my big take home, Francesca, from
this with uh atopical is get thediagnosis right.
Like, you know, people like,oh, I tried that and it didn't
work.
I'm like, did you have thediagnosis or were you just
shotgunning?
And that's that's fine to startthere.
But if you really want to honedown and, like you said, make a
precise patient-oriented uhspecific treatment, then you
(04:06):
need to get it right.
Francesca Solari (04:08):
Yeah, absolutely.
And it's actually not relatedto this paper, but one of my
biggest pet peeves is the termidiopathic, because to me,
nothing is actually idiopathic.
It just means that we've missedthe diagnosis.
Lisa Fortier (04:20):
Fair.
Good point.
Um what sparked your researchinterest in this?
Was there a specific case ordid you read about it in human
literature?
What, what, what drove you tostart investigating this in
veterinary medicine?
Francesca Solari (04:33):
Yeah, well, I've been really lucky here at
UF, where I did my residency,um, that I've worked with some
fantastic mentors, both in lifeand in surgery and also in
research.
Um, and I've worked primarilyhere with Dr.
Brad Cast, who's one of oursurgeons and also very big in
the minimally invasive surgeryworld.
Um, and he had done some workwith microwave ablation of liver
(04:56):
tumors.
Um, and one of the challengeswith microwave ablation uh is
the you need to make sure thatyou're getting um coagulation of
the entire tumor and you'reusing a little pinpoint uh
needle to stick it in the tumor.
And if you're not in the idealspot or you don't do multiple
ablation zones, you're not goingto get complete necrosis or
(05:19):
coagulative necrosis of thattumor.
Um, and so one of the thingsthat kind of sparked the
interest in using laparoscopicultrasound of the liver was
using it to optimize microwaveablation and even microwave
ablation minimally invasively.
So doing it through alaparoscopic approach.
Um, so that's really kind ofwhat started it.
And then diving onto the humanside.
And I think honestly, for a lotof the research in veterinary
(05:41):
medicine, we are so lucky tohave our human counterparts to
look to and kind of help guideour research in what directions
we go next.
Um, but there's just so muchwork looking at laparoscopic
ultrasound on the human side andhow it can maximize patient
outcomes for minimally invasivesurgery and not just for the
liver, for other kind ofindications as well.
Um, and that just reallyspiraled into a couple of my
(06:04):
research projects that I've doneover the years.
Lisa Fortier (06:07):
That's fantastic.
Yeah, I think in veterinarymedicine, it's really, you know,
we inform human medicine too.
So it's really a nicetranslational one health
approach.
Yeah.
Sarah asked you earlier whatwere some of the take-home
messages, but always when we dostudies like this, there's
something that surprises us andthen gets us to do another
study.
So what surprised you from thisarticle?
Francesca Solari (06:28):
Yeah, I mean, um, not a lot surprising in the
sense that I was anticipating wewere probably going to find
more lesions with thelaparoscopic ultrasound, and um
it was going to be moresensitive just because we have
our human kind of counterpartpapers to look to, and that's
what they've found.
But I think the one kind offinding of the study that isn't
really a major finding, um, butthat interested me or surprised
(06:50):
me is that all of the lesionsthat we biopsied were benign.
Um, and you know, to somedegree, that's probably patient
selection and that thesepatients were largely presenting
for, you know, chronic liverenzyme elevations, et cetera.
But almost all of our patientshad liver nodules.
And I think that that's just animportant reminder that as we
(07:10):
get more and more diagnosticsthat, you know, give us more
information and maybe we findmore nodules, even in a patient
that has liver cancer, we needto be cognizant of the fact
that, you know, it doesn'tnecessarily mean they have
metastatic disease.
Um, and so, you know, part ofum the concept behind
laparoscopic ultrasound as astaging tool is that it should
(07:31):
be paired with biopsies and notjust kind of used to condemn the
patient and say they havemetastatic disease without
further evaluation.
Lisa Fortier (07:39):
Yeah, I mean, this isn't cancer, but in the, I'm
an equine orthopedic surgeon onour side of the of the gate.
People are doing ultrasoundexams of, for example, tendons
and ligaments uh on pre-purchaseexams, and they're they're
incidental findings, right?
But the horses that use yourword condemned, and it's like
put it together with a wholefunction.
(08:00):
It's not it's not just animaging test.
Francesca Solari (08:03):
Yeah, absolutely.
I think it's it's this catch22, right?
Because um, as we develop moreand we become more advanced in
veterinary medicine, we get morediagnostics that give us more
information.
It's really important toremember, A, you know, remember
that we need to interpret it inlight of the patient and
correlate with our clinicalfindings.
Um, but also, you know,remember why we're doing our
(08:26):
diagnostics and why they'reindicated and not just kind of
throw a patient in the CT um,you know, because you're gonna
find incidental findings.
Sarah Wright (08:34):
Exactly.
Choosing diagnostics based onwhat the result, if that's gonna
change your plan of action,basically.
So yeah, I even challenge myown like cats veterinarians
sometimes when I bring them in.
I'm like, okay, so you want todo this chemistry plan.
Well, what are we gonna find onthat?
It's gonna change our course ofaction, or are we just doing it
to do it?
So yeah, exactly.
So what are the next steps toresearch then for you?
Francesca Solari (08:52):
Yeah, I mean, I think that um this, you know,
what are where I would like tosee this go is similar to the
way that they do it on the humanside is, you know, the patients
go through their preoperativestaging.
So they go through their CT,they go through their, you know,
transabdominal ultrasounddepending on, you know, what you
choose to do.
Um, and then before going toany kind of curative intent
(09:13):
surgery, they undergolaparoscopic biopsies with
laparoscopic ultrasound.
Because I think not only doesthat get us more information, we
may find additional nodules, weget biopsy samples to know what
the primary tumor is, but alsoto know if there's any evidence
of metastatic disease.
And then it could also evenguide, you know, our surgical
plan.
So we can evaluate the tumorlaparoscopically, get an idea
(09:37):
of, you know, is this actuallysurgically resectable?
Or is this something where weneed to be considering a
different type of therapy likechemoembolization or radiation
therapy?
Uh, is this something we canlaparoscopically remove?
Um, so do like a laparoscopicliver resection.
Or if we find that there'sdiffuse disease, then do we
consider something likemicrowave ablation?
(09:59):
Um, and so really optimizingthe specific treatment plan for
each patient without just goingin and doing a full exploratory
laparotomy and finding out thatmaybe we can't even surgically
resect that tumor, or maybe itwasn't the best option for that
patient specifically.
Sarah Wright (10:15):
Do you see a role in for AI in this area of
research?
Francesca Solari (10:18):
Yeah, I mean, it's I think there's so much
room for AI in veterinarymedicine, and we're already
starting to see that transition.
Um, for this specifically, Ithink there could be a role, and
I guess we'll see how AI kindof comes into diagnostic imaging
over the next decade or so.
Um, but I think there coulddefinitely be a role in trying
to pick up those liver nodules,you know, on the ultrasound,
(10:41):
because one of the challengesthat we faced in this um study
was, you know, you're looking atthe laparoscopic image on the
screen.
Um so you're watching thevideo, but you're also trying to
look at the ultrasound monitorseparately.
And so you're having to kind ofgo back and forth between the
two.
And so even though we picked upmore nodules, we may have
missed, you know, potentiallysome um liver lesions or liver
(11:03):
nodules.
Lisa Fortier (11:04):
Yeah, really good point.
Uh you spoke earlier about thegreat mentorship that you have
received and lots of differentaspects of uh life and
profession.
How did your training and allthat mentorship prepare you to
write this article?
Francesca Solari (11:19):
I think um in a couple of different ways.
Uh, I've been very lucky uhhere at UF where we have a
master's degree program.
Um, and so you know, ourresidency is a little bit
longer, but it really affords usthe opportunity to get involved
in prospective clinical trialsbecause as I'm sure you know,
those take time.
Um, they take a lot of energy.
(11:39):
Um, but I think that they giveus very valuable information.
And I think there's a time andplace for retrospectives, but
also, you know, we need both umprospective and retrospective
studies.
So being here and having thatmaster's degree and having that
extra time to do a clinicaltrial has really helps me with,
you know, doing this research.
Um, but also just havingmentors here who are constantly
(12:02):
willing to try new things andpush the envelope a little bit.
Um and then being across thestreet from Shans, UF Shans,
which is the human hospital, um,and having people who, you
know, that one health approach,like we mentioned, where we can
um chat with them about how theymanage their patients.
If we're trying something newfor the first time, they can
come over and help us.
(12:22):
Um, so I think that all ofthose things together have made
it so that I can, you know, dothis type of research, which I
feel very lucky.
Sarah Wright (12:30):
Well, we love hearing that.
So, Francesca, you share a lotof really valuable information
today with us.
And now we're gonna ask yousomething really hard to do.
You can boil it down to onepiece of information, like
veterinarians are gonna go see aclient, they're gonna be
talking about this.
What is one thing they need toshare with them?
So, Francesca, what is onepiece of information the
veterinarian should know aboutlaparoscopic ultrasound for
(12:51):
evaluation of the liver in dogswith clinical liver disease?
Francesca Solari (12:55):
I think for me, just knowing that it's an
available option.
And so, you know, when aveterinarian is faced with one
of these patients that eitherhas uh, you know, elevated liver
enzymes or, you know, has aliver tumor, um, realizing that
referral for that kind of goldstandard of care, um, getting
more information or getting themost information we can before
(13:17):
we dive into any kind oftreatment is out there.
Um, and so just being aware ofthat.
Sarah Wright (13:22):
And on the other side of the relationship, that's
one thing that clients shouldknow about this.
Francesca Solari (13:26):
I think on the same note, um, just knowing
that there are um, you know,options available for people and
they can um, you know, havethat further information about
their pet and they can um, youknow, think about the best
treatment option for their petbefore they have to dive into
anything.
I think having more informationfor owners helps give them
(13:49):
peace of mind.
Um, so I think that to me isreally the most valuable aspect
for clients.
Lisa Fortier (13:54):
Yeah, one of my favorite sayings is knowledge is
powered.
Absolutely.
Uh Francesca, thanks so much.
This is really fascinating.
I didn't know about this untilI read your article.
So thank you for sharing itwith Jabma.
Yeah, of course.
As we wind down a little bit,we like to ask just a more fun
question.
So for you, I would like toknow what is your favorite
(14:15):
animal fact?
Francesca Solari (14:17):
Um, well, I'm a big fan of otters.
I love otters.
And um, I recently found outthat otters like to juggle and
they also like to save rocksthat are their favorite rocks,
and they keep it in their littlebelly pouch.
Lisa Fortier (14:30):
So I did not know that.
We we've heard that they sleep,I don't remember what it's
called.
They sleep holding hands sothat they they're what's it
called?
Sarah Wright (14:40):
Rats.
Lisa Fortier (14:41):
Rats.
Francesca Solari (14:43):
Yeah, they're fascinating creatures.
They're not the nicest though,actually, to people.
Sarah Wright (14:49):
Yeah, Francesca, I came to the AVMA from the
Vancouver Aquarium.
We had quite the robust otterpopulation there.
So they definitely keep you onyour toes, that is for sure.
They like to save their littlerocks too, and sometimes they'll
try to use it to like excavateout of their exhibits.
So always keep you in close eyeat them.
They're very smart.
Well, thank you so much,Francesca, for being here today
(15:10):
and for also sharing your workwith AJVR.
We appreciate it.
Of course.
Thank you so much, guys.
I really appreciate it.
And to our listeners, you canread Francesca's article on
AJVR.
I'm Sarah Wright with LisaFortier.
Be on the lookout for nextweek's episode, and don't forget
to leave us a rating and reviewon Apple Podcasts or whatever
platform you listen to.
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