Efficacy of FDG PET/CT Imaging for Venous Thromboembolic Disorders

Hess, Søren; Madsen, Poul Thøis; Iversen, Else Dalsgaard; Frifelt, J J; Høilund‐Carlsen, Poul Flemming; Alavi, Abass

doi:10.1097/rlu.0000000000000453

Cited by 23 publications

(8 citation statements)

References 14 publications

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“…[10] In addition, venous thrombosis uptake subsides in the chronic phase to normal values at approximately 3 months, allowing for proper distinction from malignancy in the absence of targeted treatment. [1234] As opposed to previously reported extensive portal vein tumor thromboses,[6] the current case illustrates the interesting pattern of branching metabolic activity in an extensive portal vein thrombosis with mild intrahepatic intensity suggestive of bland thrombosis, highlighting once more the instrumental role of FDG-PET in thrombosis and cancer staging. Unfortunately, in this case, cancer stage was not suitable for curative intent, and the patient received appropriate palliative therapy.…”

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confidence: 49%

“…Due to neutrophils and macrophages activated by the acute inflammatory phase of venous thrombosis, FDG-PET sports high sensitivity and specificity. [1234] Various cancers are associated with bland or tumor thrombosis, including hepatocellular carcinoma, pancreaticobiliary carcinoma, renal cell carcinoma, and various adenocarcinomas. [56789] As proposed by recent literature, FDG-PET may differentiate direct tumor invasion from bland thrombus.…”

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confidence: 99%

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18F-fluorodeoxyglucose positron emission tomography/computed tomography in extensive bland portal vein thrombosis from retroperitoneal adenocarcinoma

et al. 2019

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A 73-year-old woman undergoing hormone therapy for previously treated localized breast cancer presented at oncology follow-up 4 years after mastectomy/radiation therapy with weight loss, night sweats, and abdominal pain. Contrast computed tomography (CT) abdomen revealed a soft-tissue mass posterior to the pancreas, several enlarged retroperitoneal lymph nodes, and a dilated portal vein. On 18F-fluorodeoxyglucose positron emission tomography/CT, metabolic activity extended along the portal vein, outlining most of the liver venous system. This “tree-like” appearance was diagnostic of recent portal vein thrombosis by vascular compression from the retroperitoneal mass. Biopsy of the mass later confirmed undifferentiated adenocarcinoma without breast cancer marker expression.

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confidence: 49%

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confidence: 99%

18F-fluorodeoxyglucose positron emission tomography/computed tomography in extensive bland portal vein thrombosis from retroperitoneal adenocarcinoma

et al. 2019

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“…By visual interpretation, DVT/PE was considered present if focal or linearly increased FDG uptake was observed within the veins/pulmonary vasculature. FDG-PET/CT was able to correctly diagnose or rule out DVT in all patients, but was positive in only two of six PE cases [14]. Based on the same data and reported in an abstract [64], the same researchers found that the volumetric parameters metabolically active volume (MAV), total lesion glycolysis (TLG), and SUVmax relative ratios were the most robust predictors of DVT, while areas under the ROC curve were 0.96 for MAV (p=0.005), 0.94 for TLG (p=0.007), and 0.89 for SUVmax (p=0.03).…”

Section: Discussionmentioning

confidence: 86%

“…without PETimaging. Of the included papers, five papers were on the diagnostic performance of PET/CT in DVT (n=3) or PE (n=3) [11][12][13][14][15], and four were on the ability of PET/CT to differentiate TT from BT [16][17][18][19]. Two papers presented data on changes in FDG uptake over time [12,20].…”

Section: Resultsmentioning

confidence: 99%

FDG-PET/CT in venous thromboembolism

Hess

Frary

Gerke

et al. 2018

Clin Transl Imaging

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Purpose: Venous thromboembolism (VTE) is common; deep venous thrombosis (DVT) and pulmonary embolism (PE) are the most common presentations. VTE may arise in the entire venous bed and the diagnosis may be difficult. VTE is a dynamic disease, inflammation is key, and FDG-PET/CT has been proposed, e.g. to detect thrombi in any anatomic location, to differentiate acute from chronic VTE, and to differentiate bland VTE from tumor thrombosis. The aim of this systematic review was to assess if the potential uses of 18 F-Fluorodeoxyglucose positron emission tomography/computer tomography (FDG-PET/CT) in VTE are described and documented in the literature. Methods: PubMed and Embase databases were searched. Duplicates and papers in other languages than English and Scandinavian were removed. Remaining papers were screened by title and abstract. Eligible papers were assessed in full-text. Results: The master search yielded 3,897 hits, 316 papers were eligible for full-text assessment. Ten papers were included; six on diagnostic performance of PET/CT in VTE, and four on the ability of PET/CT to differentiate bland VTE from tumor thrombosis. Three papers were prospective, seven were retrospective. Conclusion: If applied early, FDG-PET/CT may have a role in diagnosing DVT, but not PE, to discriminate acute from chronic VTE, and to demonstrate recurrent VTE. FDG-PET/CT is by some considered adept in differentiating bland VTE from tumor thrombosis, but we find this controversial due to FDG avidity in bland VTE. FDG-PET/CT may be feasible when screening for occult malignancy. However, in all mentioned areas, available literature is too sparse and too heterogeneous to allow firm conclusions.

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“…With reference to related mechanisms and experience, PET may have a greater role in the detection of venous thromboembolism compared with the detection of pulmonary embolism [ 80 , 81 ]. A prospective study evaluated the significance of 18 F-FDG PET in the detection of lower extremity venous thrombosis and pulmonary embolism [ 82 ]. The results showed that physicians diagnosed all 7 patients with lower extremity venous thrombosis based on the hypermetabolism of thrombus and blood vessels, but only 2 of 6 patients with pulmonary embolism were accurately diagnosed [ 82 ].…”

Section: Potential Role Of Pet In Covid-19-derived Complicationsmentioning

confidence: 99%

Positron emission tomography in the COVID-19 pandemic era

Jin

Luo

Qian

et al. 2021

Eur J Nucl Med Mol Imaging

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Coronavirus disease 2019 (COVID-19) has become a major public health problem worldwide since its outbreak in 2019. Currently, the spread of COVID-19 is far from over, and various complications have roused increasing awareness of the public, calling for novel techniques to aid at diagnosis and treatment. Based on the principle of molecular imaging, positron emission tomography (PET) is expected to offer pathophysiological alternations of COVID-19 in the molecular/cellular perspectives and facilitate the clinical management of patients. A number of PET-related cases and research have been reported on COVID-19 over the past one year. This article reviews the current studies of PET in the diagnosis and treatment of COVID-19, and discusses potential applications of PET in the development of management strategy for COVID-19 patients in the pandemic era.

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Efficacy of FDG PET/CT Imaging for Venous Thromboembolic Disorders

Cited by 23 publications

References 14 publications

18F-fluorodeoxyglucose positron emission tomography/computed tomography in extensive bland portal vein thrombosis from retroperitoneal adenocarcinoma

18F-fluorodeoxyglucose positron emission tomography/computed tomography in extensive bland portal vein thrombosis from retroperitoneal adenocarcinoma

FDG-PET/CT in venous thromboembolism

Positron emission tomography in the COVID-19 pandemic era

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