Venous thromboembolism detected by FDG-PET/CT in cancer patients: a common, yet life-threatening observation.
Fatemeh Kaghazchia b, Austin J. Borjaa c d e, Emily C. Hancina f, Abhijit Bhattarua b, Donald Detchoua c d e, Siavash Mehdizadeh Seraja b, Chaitanya Rojulpotea b, Søren Hessg, Lorenzo Nardoh, Peter Edward Gabrieli j, Scott M. Damrauerk l, Thomas J. Wernera b, Abass A. Alavia b, Mona-Elisabeth R. Revheima m n
- aDepartment of Radiology, Hospital of The University of Pennsylvania Philadelphia, PA, USA
- bDepartment of Radiology Hospital of the University of Pennsylvania Philadelphia PA USA
- cPerelman School of Medicine at The University of Pennsylvania Philadelphia, PA, USA
- dDepartment of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
- ePerelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- fLewis Katz School of Medicine at Temple University Philadelphia, PA, USA
- gDepartment of Radiology and Nuclear Medicine, Hospital Southwest Jutland Esbjerg, Denmark
- hDepartment of Radiology, University of California Davis Sacramento, CA, USA
- iDepartment of Radiation Oncology, Hospital of The University of Pennsylvania Philadelphia, USA
- jDepartment of Radiation Oncology, Hospital of The University of Pennsylvania, Philadelphia, USA
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Abstract
F]-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT). All subjects underwent PET/CT imaging 60 minutes after FDG injection. Images were visually assessed for increased FDG uptake within the venous lumen. For positive cases, clinical follow-up and Doppler ultrasonography and/or contrast-enhanced CT scans were reviewed. FDG-PET/CT revealed abnormal uptake in the venous system of 26 (19.8%) patients. Eighteen (69.2%) had a history of DVT, and 13 (50%) had a history of PE. The most common site of thrombosis was the inferior vena cava (IVC) (n=14, 53.8%), followed by lower extremities veins (n=9, 34.6%), jugular veins (n=2, 7.7%), and superior vena cava (n=1, 3.8%). The presence of thrombi was confirmed by reviewing clinical follow-up in 6 (23.1%) patients. Among this group, thrombosis was detected in lower extremity veins (n=4, 15.8%), jugular veins (n=1, 3.8%), and IVC (n=1, 3.8%). Our study demonstrates that thrombi prior to their clinical manifestation can be detected by FDG-PET/CT in cancer patients. Moving forward, physicians must carefully consider the venous system when reporting FDG-PET/CT for cancer patients.
TL;DRIt is demonstrated that thrombi prior to their clinical manifestation can be detected byFDG-PET/CT in cancer patients, and physicians must carefully consider the venous system when reporting FDG- PET/CT for cancer patients. (Semantic Scholar)