{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T07:26:13Z","timestamp":1782631573015,"version":"3.54.5"},"reference-count":51,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Illinois Urbana-Champaign Companion Animal Research Grant","award":["Wayne and Josephine Spangler Fund"],"award-info":[{"award-number":["Wayne and Josephine Spangler Fund"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Spatial heterogeneity within bone marrow significantly affects diagnostic accuracy in human and veterinary medicine, where single-site sampling may fail to detect focal disease processes. However, optimal bone marrow sampling strategies for canine hematologic disease diagnosis remain unclear, representing a critical knowledge gap in veterinary diagnostic pathology. We hypothesized that multi-site bone marrow core sampling would provide superior diagnostic accuracy compared to current single-site sampling standards in canine patients. The primary aim was to evaluate diagnostic capture probability of sampling one to four bone marrow sites in dogs with suspected hematologic disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods and findings<\/jats:title>\n                    <jats:p>Sixteen dogs with suspected hematologic disease underwent bone marrow trephine biopsies from four anatomical locations (bilateral proximal humerus and iliac crest) using the ARROW OnControl Powered Driver system. Two board-certified clinical pathologists independently evaluated 64 masked bone marrow samples. Diagnostic accuracy was assessed using truth set methodology, with statistical analysis including mixed-effects logistic regression and bootstrap confidence intervals. Multi-site core sampling significantly improved diagnostic capture probability. Moving from one to two sites increased diagnostic accuracy from 76.6% to 94.8% under the permissive rule (18.2% improvement, P\u2009&lt;\u20090.0001), and from 28.1% to 47.9% when both pathologists agreed (19.8% improvement). Significant site-specific differences were observed in myeloid-to-erythroid ratios and megakaryocyte counts. Overall, 13.3% of samples were nondiagnostic, with modest inter-pathologist agreement (\u03ba\u2009=\u20090.30, 42% agreement).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Multi-site bone marrow core sampling provides clinically meaningful improvements in diagnostic accuracy for canine hematologic diseases, with the greatest benefit achieved by adding a second sampling site to current single-site protocols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0343251","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T18:29:01Z","timestamp":1772044141000},"page":"e0343251","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Multi-site bone marrow core biopsy improves diagnostic accuracy in dogs with hematologic 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