Performance of 18F fluoro-2-désoxy-D-glucose positron emission tomography/computed tomography for the diagnosis of venous thromboembolism

Thromb Res. 2015 Jan;135(1):31-5. doi: 10.1016/j.thromres.2014.10.008. Epub 2014 Oct 20.

Abstract

Introduction: Thrombosis and inflammation are intimately linked. Inflammatory component of venous thromboembolism (VTE) may allow the use of FDG positron emission tomography / computed tomography (FDG PET/CT) in the detection of thrombotic process. Published studies remain limited and contradictory. We aimed at evaluating the performance of FDG PET/CT in the detection of VTE in a population of patients enrolled in a prospective study evaluating FDG PET/CT for cancer screening in etiological assessment of idiopathic VTE.

Materials and methods: The first consecutive 100 patients who underwent FDG PET/CT were included. Visual and quantitative analyses of vascular axes was performed and compared with lower limb veins compression ultrasonography, lung scintigraphy and/or computed tomography pulmonary angiography.

Results: Out of the 100 patients, 63 presented lobar pulmonary embolism for a total of 217 embolic sites and 62 had a deep vein thrombosis for a total of 143 thrombotic sites. Regarding pulmonary embolism, sensitivity and specificity of FDG PET/CT were 3% (95%CI: 1-6%) and 99% (95%CI: 98-100%). SUV max ratio between pulmonary embolism location and non-pathological contralateral vessel was 1.04±0.18 (p=0.7). Regarding deep vein thrombosis, sensitivity and specificity were 31% (95%CI: 24-39%) and 88% (95%CI: 81-92%). The metabolic activity was significantly higher than in contralateral vessels (p<0.001), with a SUV max ratio of 1.25±0.53, but without any significant SUVmax threshold applicable in routine practice for deep vein thrombosis diagnosis.

Conclusions: FDG PET/CT is not accurate enough for the diagnosis of VTE.

Keywords: Deep Vein Thrombosis; FDG PET/CT; Inflammation; Pulmonary embolism; Venous thromboembolism.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Inflammation
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Perfusion
  • Positron-Emission Tomography*
  • Prospective Studies
  • Reproducibility of Results
  • Tomography, X-Ray Computed*
  • Treatment Outcome
  • Ultrasonography
  • Venous Thromboembolism / diagnostic imaging*

Substances

  • Fluorodeoxyglucose F18