Efficacy of FDG PET/CT Imaging for Venous Thromboembolic Disorders

PURPOSE: In recent years, several case reports have described venous thromboembolism (VTE) on FDG PET/CT. In this short communication, we present results from a proof-of-concept pilot study aimed at providing some preliminary data on the efficacy of FDG PET/CT in prospective patients with suspected VTE. PATIENTS AND METHODS: Fifteen patients with suspected deep venous thrombosis (DVT) and/or pulmonary embolism (PE) were included prospectively and underwent a whole-body FDG PET/CT. Patients were divided into 4 groups as follows: DVT+ (DVT proven by high clinical suspicion and positive compression ultrasound), DVT- (DVT ruled out by low clinical suspicion and negative compression ultrasound), PE+ (PE proven by high clinical suspicion and positive lung scintigraphy), and PE- (PE ruled out by low clinical suspicion and normal lung scintigraphy). Images were interpreted visually by 2 experienced nuclear medicine physicians independently and without knowledge of other imaging results. RESULTS: Seven DVT+, 6 DVT-, 6 PE+, and 1 PE- were included. Five patients were suspected of both DVT and PE. FDG PET/CT correctly diagnosed the presence or lack of DVT in all patients, whereas results are more ambiguous in PE with only 2 of 6 PE patients showing FDG avidity. The readers agreed in all cases. CONCLUSIONS: Although further studies are warranted for further clarification, our preliminary data substantiate that FDG PET/CT is a viable modality for assessing VTE, at least for DVT. We believe our results add positively to the limited data on this subject and are promising enough to warrant further larger series.