Staging CT scans in oncology patients revealed an overall 6.3% prevalence of unsuspected venous thromboembolism, which was more common in inpatients (RR 1.4) and advanced disease (RR 2.0).
Observational (n=435)
What is the prevalence of unsuspected venous thromboembolic disease on staging CT scans in oncology patients?
Unsuspected venous thromboembolism is present in 6.3% of oncology patients undergoing staging CT scans, highlighting the importance of assessing for DVT and PE during these routine imaging studies.
OBJECTIVE: The purpose of our study was to determine the prevalence of unsuspected venous thromboembolic disease--specifically, of pulmonary embolism (PE) and of inferior vena cava (IVC), iliac, and iliofemoral deep venous thromboses (DVTs)--in oncology patients on staging CT scans of the thorax, abdomen, and pelvis. MATERIALS AND METHODS: Retrospective analysis was performed on 435 consecutive staging CT thorax, abdomen, and pelvis scans performed on a variety of oncology patients for the presence of venous thromboembolic disease. The patient group consisted of 198 men and 237 women who ranged in age from 20 to 79 years (mean, 55 years). Disease type, stage, concomitant surgery or chemoradiation therapy regimes, anticoagulation status, and 6-month clinical and radiologic follow-up findings were recorded. RESULTS: We found a prevalence of 6.8% (23/339) unsuspected iliofemoral, 1.2% (4/339) unsuspected common iliac, and 0.3% (1/315) unsuspected IVC DVTs and 3.3% (13/397) unsuspected PEs occurring in patients with a wide range of malignancies. The overall prevalence of unsuspected venous thromboembolism (i.e., DVT, PE, or both) was 6.3% (25/397). DVT, PE, and venous thromboembolic disease were more common in inpatients (p = 0.002, 0.004, 0.023; relative risk RR = 1.6, 2.1, 1.4, respectively) and in those with advanced disease (p = 0.001, 0.01, 0.001; RR = 2.2, 1.8, 2.0, respectively). CONCLUSION: Although there is a known increased risk of thromboembolism (DVT and PE) in oncology patients, many cases are not diagnosed, which can prove fatal. Staging CT simultaneously affords one sole investigation of the pulmonary, IVC, iliac, and upper femoral veins, thereby providing an important diagnostic opportunity. Assessment for DVT and PE is important when reviewing staging CT scans.
Cronin et al. (Tue,) conducted a observational in Oncology (n=435). Staging CT scans was evaluated on Prevalence of unsuspected venous thromboembolism (DVT, PE, or both). Staging CT scans in oncology patients revealed an overall 6.3% prevalence of unsuspected venous thromboembolism, which was more common in inpatients (RR 1.4) and advanced disease (RR 2.0).