18F-FDG PET in the Evaluation of Acuity of Deep Vein Thrombosis

Abstract

Purpose 18F-FDG PET has been used for vascular disease, but its role in deep vein thrombosis (DVT) remains prospectively unexplored. Patients and Methods Whole-body 18F-FDG PET/CT scans were performed in patients 1 to 10 weeks after onset of symptomatic DVT (n = 12) and in control subjects without DVT (n = 24). The metabolic activity (SUVmax) of thrombosed and contralateral nonthrombosed vein segments was determined. The sensitivity and specificity of 18F-FDG PET/CT for the diagnosis of DVT were determined by receiver operating characteristic curve analyses. In 2 patients with DVT, changes in the metabolic activity of thrombosed vein segments in serial 18F-FDG PET scans. Results The metabolic activity in thrombosed veins [SUVmax, 2.41 (0.75)] was visually appreciable and significantly higher than in nonthrombosed veins in either the contralateral extremity of patients with DVT [SUVmax, 1.09 (0.25), P = 0.007] or control subjects [1.21 (0.22), P < 001]. The area under the receiver operating characteristic curve for SUVmax was 0.9773 (P < 001), indicating excellent accuracy. An SUVmax threshold of greater than 1.645 was 87.5% sensitive and 100% specific for DVT. Metabolic activity in thrombosed veins correlated significantly with time from DVT symptom onset (decrease in SUVmax of 0.02/d, P < 0.05). Best-fit-line analyses suggested that approximately 84 to 91 days after acute DVT, the maximum metabolic activity of thrombosed veins would return to normal levels. Conclusions 18F-FDG PET/CT is accurate for detecting acute symptomatic, proximal DVT. Metabolic activity in thrombosed veins decreases with time, suggesting that 18F-FDG PET may be helpful in assessing the age of the clot.

In Vitro PET Imaging of a Miniature Ventricular Assist Device

“…All images were reconstructed using 2-dimensional orderedsubsets expectation maximization and analyzed by ASIPro software, with all necessary quality assurance checks and calibrations being performed before imaging. 18 F-NaF was synthesized in house. Briefly, 18 F-fluoride was diluted with deionized water and passed through a cationexchange (H 1 form) cartridge and an Accell Plus QMA cartridge (Sep-Pak).…”

“…The reported uses of PET imaging in the VAD patient population have been limited to detection of infection (1,(13)(14)(15). In this study, we examined the effect of PET imaging on the MVAD Ò pump, using an in vitro flow loop with two commonly applied radiopharmaceuticals, 18 F-NaF and 18 F-FDG.…”

“…PET technology traces the biologic pathway of compounds in vivo, providing quantitative parameters on cell viability, cell proliferation, and the metabolic activity of tissue. Two commonly used radiotracers in clinical scanning are 18 F-FDG and 18 F-NaF. The use of 18 F-FDG is, internationally, primarily oncologic.…”

“…The radionuclides that are used in PET scans are called contrast agents. These are typically isotopes with short half-lives, such as 13 N (10 min) and 18 F (110 min). When these contrast agents are incorporated into compounds normally used by the body, such as glucose, they are known as radiotracers.…”

“…The use of 18 F-FDG is, internationally, primarily oncologic. 18 F-NaF is commonly used for detecting and evaluating metastatic bone cancer (11,12).…”