About

Mila Freire is an Associate Professor at the College of Veterinary Medicine at NC State University. Her research focuses on various areas within veterinary medicine, including infectious diseases, immunology, and regenerative medicine. She is involved in multiple research centers, consortia, and laboratories that conduct studies on clinical sciences, molecular biomedical sciences, and population health and pathobiology. Her work contributes to understanding disease mechanisms and developing therapeutic strategies for animal health. She is actively engaged in teaching, research, and clinical collaborations within the college, supporting the advancement of veterinary medicine through her expertise and leadership.

Research topics

• Surgery
• Medicine
• Internal medicine
• Pathology
• Cardiology

Selected publications

• Establishment of a sedation threshold score for orthopedic radiographs in dogs and evaluation of inter-rater reliability and accuracy of video-based assessment.

  PubMed · 2026-02-01

  articleOpen accessSenior author

  Background: Sedation scales are commonly used to assess sedation levels in dogs, but no threshold scores exist to guide decisions on the need for additional sedatives. Objective: The objectives were to determine sedation score thresholds for obtaining orthopedic radiographs without restraint, evaluate inter-rater reliability, and compare video and real-time scoring. Animals and procedure: the area under the curve (AUC). Inter-rater reliability was assessed using the intraclass correlation coefficient, and agreement between scoring methods was analyzed using the Bland-Altman approach. Results: The threshold sedation scores were ≥ 16/21 (AUC = 0.71) for all radiographs and ≥ 12/21 (AUC = 0.77) for stifle radiographs, both indicating moderate ability to distinguish between adequately and inadequately sedated dogs. The inter-rater reliability of combined scores was very good (intraclass correlation coefficient > 0.81) for all raters, and the mean bias between video and real-time scoring was -0.08. Conclusion and clinical relevance: video.

  PublisherOA PDF

• IMAS, Unique TB-PET System with DOI and TOF: First Clinical Tests

  2025-11-01

  article

  Total Body (TB) - PET is becoming more popular with about 50 systems already installed worldwide. TB-PET are characterized by axial coverages ranging <tex xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">$100-200 ~\text{cm}$</tex>, including timing capabilities in the range of 180-250 ps. These systems have shown great potential in several application fields, due to their significantly increased sensitivity (both physical and clinical), and to the possibility to study correlations between distant organs in a single exam. However, available TB-PET are very expensive and they not enable depth of interaction (DOI) information. In this work we present a unique TB-PET based on semi-monolithic LYSO scintillators. The system has 70 cm axial coverage thus allows to image most relevant organs, combined with DOI capabilities improving spatial resolution performance towards the edge of the field of view. We have compared our current results with state-of-the-art TB-PET scanners, showing a factor 2-3 better spatial performance at 30 cm off-radial positions. First clinical images have been already acquired. The reconstructed images also pinpoint the advantages of improved impact determination (both monolithic and DOI directions), better delineating small and multi-centric tumors.

  PublisherDOI

• Denoising of Small Animal PET Scans Using Deep Image Prior

  2025-11-01

  article

  A custom-made preclinical PET insert capable of simultaneous PET, MRI, and Focused Ultrasound was developed for small animal studies PET reconstructed images might be degraded by statistical noise when simultaneously acquired with the other systems. While traditional denoising methods reduce noise, they may blur fine details. Moreover, deep learning alternatives require large, paired datasets rarely available in PET. This work aims to integrate Deep Image Prior (DIP), which offers an unsupervised solution using only a single noisy image, assessing its performance with phantom data acquired with the multimodal PET insert. In particular, a 3D U-Net-based DIP architecture was implemented with two different skip-connection strategies, namely: addition and concatenation. The framework was optimized using the L-BFGS algorithm and applied to reconstructed PET images using 50 MLEM iterations of the small animal Image Quality (IQ) phantom filled with <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">18</sup> F-FDG. Image quality was evaluated through contrast recovery coefficient (CRC), standard deviation (STD), line profiles, and qualitative assessment. Results show that DIP-add and DIP-concat reduce noise by 41 % and 23 %, with CRC drops of 11 % and 8 %, respectively. DIP-concat better preserves some details, while DIPadd suppresses more the noise. Both stabilize at high iterations, avoiding noise buildup. These findings demonstrate DIP's potential to enhance the image quality in our novel PET system and support its future application in in vivo small animal studies.

  PublisherDOI

• Use of a novel subcutaneous injection site in the region of acupuncture point GV20 for premedicating cats before general anesthesia.

  PubMed · 2025-05-01

  article

  Objective: subcutaneous (SC) injection at or adjacent to the Governing Vessel 20 acupuncture location (GV20adj), interscapular SC injection (iscapSC), or lumbar epaxial intramuscular (IM) injection. Animals: = 20) groups. Procedure: Premedication consisted of dexmedetomidine (10 μg/kg) and methadone (0.2 mg/kg). Sedation, infrared temperature (GV20adj and iscapSC sites), and signs of nausea and vomiting were recorded. Results: = 0.021). Conclusion: GV20adj injection was similar to, but more consistent than, IM injection, and superior to iscapSC injection. Higher GV20adj site temperature suggested greater perfusion, potentially explaining differences in sedation and vomiting. Clinical relevance: The GV20adj injection route in cats is a viable route for premedication or sedation.

  Publisher

• Dose Verification after Proton Therapy Treatment using Positron Emission Tomography

  2024-09-25

  article
  PublisherDOI

• Subclinical bacteriuria and surgical-site infection in 140 dogs with orthopedic and neurological conditions.

  PubMed · 2024-12-01

  articleOpen accessSenior author

  Objectives: This study aimed to determine the prevalence, risk factors, and types of bacterial isolates associated with subclinical bacteriuria (SBU) in dogs with reduced mobility; and to explore the influence of SBU on surgical-site infection (SSI) in dogs treated surgically for their conditions. Animals: We studied 140 client-owned dogs. Procedure: Medical records of dogs with orthopedic and neurological conditions from 3 academic referral hospitals were reviewed. Dogs receiving antimicrobials or showing lower urinary tract signs were excluded. Using generalized linear models, clinical, procedural, and postoperative variables were evaluated as possible risk factors for SBU and SSI. Results: spp. in 1 dog). Four of the 10 dogs that developed SSI received postoperative antimicrobial therapy. The prevalence of SBU and types of bacterial isolates were similar to those in previous reports. Significant risk factors for developing SBU and its association with SSI were not identified. Conclusion and clinical relevance: Screening and treating for SBU preoperatively remains controversial.

  PublisherOA PDF

• Comparison of sedation with dexmedetomidine administered subcutaneously at 2 different locations on the head in dogs.

  PubMed · 2024-04-01 · 3 citations

  articleOpen accessSenior author

  Objective: This study aimed to compare the sedative effects of dexmedetomidine administered to dogs subcutaneously (SC) at the Governing Vessel 20 (GV20) acupuncture point and at another point on the head. Animals and procedure: < 0.05. Results: < 0.001). Adverse events were infrequent and self-limiting. Conclusion: Our study provides evidence that SC administration of dexmedetomidine on the head, at the GV20 point or at the base of the ear, is easy and provides a sufficient level of sedation to obtain orthopedic radiographs in dogs.

  PublisherOA PDF

• Clinical findings and prognostic factors for immediate survival in 33 dogs undergoing surgery for biliary peritonitis

  Veterinary Surgery · 2024-11-06

  articleOpen access

  OBJECTIVE: To report demographics, clinical signs, physical examination, diagnostic test results, surgical findings, and prognostic factors for in-hospital postoperative mortality following biliary peritonitis surgery in dogs. STUDY DESIGN: Retrospective, multi-institutional cohort study. ANIMALS: Thirty-three client-owned dogs. METHODS: The medical records of dogs that underwent surgery for biliary peritonitis between 2015 and 2021 were reviewed. Dogs were included if they had a definitive diagnosis of biliary peritonitis and a surgery report. Information on demographics, clinical signs and duration, physical examination findings, laboratory and diagnostic imaging results, surgery, perioperative medical treatment, and complications for each patient was obtained. Statistical analyses were performed to identify risk factors that affected survival. RESULTS: Cholecystectomy was the procedure most frequently performed (31/33, 94%). The overall mortality rate was 36% (12/33). Survival was affected negatively by hyperbilirubinemia (p = .049), administration of vasopressors (p = .002), renal dysfunction (p = .008), and number of postoperative complications (p = .005). A mortality rate of 50% was observed in dogs with a total bilirubin level greater than 60.5 μmol/L. There was no difference in mortality rate between septic and nonseptic biliary effusions. CONCLUSION: New prognostic factors associated with in-hospital postoperative mortality in dogs treated surgically for biliary peritonitis were identified, while others that had been reported previously were confirmed. A preoperative bilirubin threshold value associated with a 50% mortality was identified. CLINICAL SIGNIFICANCE: Additional information that could help to predict survival in dogs with biliary peritonitis has been provided. However, further research is warranted.

  PublisherOA PDFDOI

• MR compatibility assesment of the edgeless preclinical PET insert: ScintoTube

  2023-11-04 · 1 citations

  article

  The combination of Positron Emission Tomography (PET) with Magnetic Resonance Imaging (MRI) constitutes a promising hybrid molecular imaging modality as it takes advantage of both the high sensitivity of PET for metabolic processes with the detailed anatomical and functional information from MRI.Simultaneous PET/MRI became a reality during the last decade and has already impacted the preclinical (small animal) field. This hybrid modality allows acquisition of perfectly registered images from both systems in a single session and thus, enables one to study different conditions and to develop accurate disease models that may help answering relevant question in the medical area. Yet, further improvements in the detector technology are still needed to completely exploit the advantages provided by these hybrid systems.Seeking the next generation of preclinical PET/MRI, we have proposed a novel PET insert design (ScintoTube) based on a single scintillator annulus to avoid gaps between detectors and thus, promote sensitivity while enhancing image resolution. We have already constructed the ScintoTube and it demonstrates excellent imaging capabilities.In this work we focus on the assessment of its MR-compatibility and on its validation to serve as an insert. The system has been evaluated inside both 7T and 9.4T Bruker MRI systems. The reported results demonstrate that there are no interferences between the systems. Hence, the ScintoTube is an attractive option for the next generation of preclinical PET/MRI.

  PublisherDOI

• Effects of Transfixation Pin Positioning on the Biomechanical Properties of Acrylic External Skeletal Fixators in a Fracture Gap Model

  Veterinary and Comparative Orthopaedics and Traumatology · 2023-06-19

  article

  Abstract Objective The aim of this study was to evaluate the biomechanical effects of transfixation pin positioning in acrylic columns of external skeletal fixators (ESF). Study Design Twenty-four type I acrylic ESF were built simulating a fracture gap-model. Transfixation pins were placed centric (n = 12) or eccentric at ¼ of the column diameter (n = 12) in the acrylic columns. Six constructs from each group were subjected to axial compression and four-point bending tests. Stiffness, yield load and mode of failure were recorded. Results Stiffness was not influenced by centring (p = 0.373), but it was higher in four-point bending than in axial compression (p &lt; 0.001). Pin positioning had no influence on the yield (p = 0.535) and failure loads (p = 0.715) in axial compression, nor on the yield load in bending (p = 0.135). Eccentric pin positioning decreased failure loads by 28% in bending (p &lt; 0.001). Conclusion Eccentric position of transfixation pins within the acrylic columns alters the biomechanical properties of type I ESF constructs. While acrylic offers several advantages, when forming the columns, frame strength will be optimized if pins are centrally located.

  PublisherDOI

Frequent coauthors

• B. Duncan X. Lascelles

  North Carolina State University

  19 shared

• Beth Case

  MedStar Washington Hospital Center

  9 shared

• Dávid Kňazovický

  North Carolina State University

  9 shared

• Elizabeth O’Toole

  Université de Montréal

  8 shared

• Javier Benito

  Université de Montréal

  8 shared

• Andrea Thomson

  North Carolina State University

  6 shared

• Tristan Juette

  Université de Montréal

  6 shared

• Dominique Gagnon

  5 shared