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FDG-PET/CT in venous thromboembolism

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Abstract

Purpose

Venous thromboembolism (VTE) is common; deep venous thrombosis (DVT) and pulmonary embolism (PE) are the most common presentations. VTE may arise from anywhere in the entire venous bed and the diagnosis may be difficult. VTE is a dynamic disease, inflammation is key, and 18F-Fluorodeoxyglucose positron emission tomography/computer tomography (FDG-PET/CT) has been proposed in the evaluation of VTE 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 FDG-PET/CT in VTE are described and documented in the literature and to appraise 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 3897 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

The available literature is too sparse to draw firm conclusions; however, FDG-PET/CT may have a role in diagnosing early DVT, but not PE, in discriminating acute from chronic VTE, in demonstrating recurrent VTE, and possibly for screening for occult malignancy.

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Authors and Affiliations

  1. Department of Radiology and Nuclear Medicine, Hospital Southwest Jutland, Finsensgade 35, 6700, Esbjerg, Denmark

    Søren Hess

  2. Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, 5000, Odense, Denmark

    Søren Hess

  3. Department of Nuclear Medicine, Odense University Hospital, 5000, Odense, Denmark

    Evan C. Frary, Oke Gerke & Poul F. Høilund-Carlsen

  4. Boehringer Ingelheim Danmark A/S, Copenhagen, Denmark

    Evan C. Frary

  5. Division of Nuclear Medicine, University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Tom Werner & Abass Alavi

  6. Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, 5000, Odense, Denmark

    Poul F. Høilund-Carlsen

Authors
  1. Søren Hess
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  2. Evan C. Frary
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  3. Oke Gerke
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  4. Tom Werner
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  6. Poul F. Høilund-Carlsen
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Contributions

SH: Protocol/project development, data analysis, literature search, literature review, writing, editing, final approval. ECF: Protocol/project development, data analysis, literature search, literature review, writing, editing, final approval. OG: Protocol/project development, data analysis, editing, final approval. TW: Protocol/project development, editing, final approval. AA: Protocol/project development, editing, final approval. PFHC: Protocol/project development, writing, editing, final approval.

Corresponding author

Correspondence to Søren Hess.

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Conflict of interest

The authors did not receive financial support from any organization for the submitted work and have no other relationships or activities that could appear to have influenced the results; thus, none of the authors (S Hess, EC Frary, O Gerke, T Werner, A Alavi, PF Høilund-Carlsen) have any conflicts of interest. ECF was not affiliated with Boehringer Ingelheim Denmark A/S during work on this project. The article does not contain any studies with human or animal subjects performed by the any of the authors.

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Hess, S., Frary, E.C., Gerke, O. et al. FDG-PET/CT in venous thromboembolism. Clin Transl Imaging 6, 369–378 (2018). https://doi.org/10.1007/s40336-018-0296-5

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