Pierre-Yves Le Roux1, Philippe Robin2, Aurélien Delluc3, Bernard Tardy4, Ronan Abgral2, Francis Couturaud3, Abdelmalek Reffad5, Grégoire Le Gal6, Pierre-Yves Salaun2. 1. Université Européenne de Bretagne, Brest, France; Université de Brest, EA3878 (GETBO) IFR 148, Brest, France; CHRU de la Cavale Blanche, Service de médecine nucléaire, Boulevard Tanguy Prigent, 29609 Brest cedex, France. Electronic address: pierre-yves.leroux@chu-brest.fr. 2. Université Européenne de Bretagne, Brest, France; Université de Brest, EA3878 (GETBO) IFR 148, Brest, France; CHRU de la Cavale Blanche, Service de médecine nucléaire, Boulevard Tanguy Prigent, 29609 Brest cedex, France. 3. Université Européenne de Bretagne, Brest, France; Université de Brest, EA3878 (GETBO) IFR 148, Brest, France; CHRU de la Cavale Blanche, Département de médecine interne et de pneumologie, Boulevard Tanguy Prigent, 29609 Brest cedex, France. 4. Université de Saint-Etienne, Saint-Etienne, France; Groupe de recherche sur la thrombose, EA3065, Saint-Etienne, France; Département des urgences, CHU de Saint-Etienne, 42055 Saint Etienne cedex 2, France. 5. Service de Médecine Nucléaire, CHU de Saint-Etienne, 42055 Saint Etienne cedex 2, France. 6. Université Européenne de Bretagne, Brest, France; CHRU de la Cavale Blanche, Département de médecine interne et de pneumologie, Boulevard Tanguy Prigent, 29609 Brest cedex, France; Université de Brest, INSERM CIC 05-02 IFR148, Brest, France; Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada.
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.
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.
Authors: Debabrata Bandyopadhyay; Tanmay S Panchabhai; Navkaranbir S Bajaj; Pradnya D Patil; Matthew C Bunte Journal: J Thorac Dis Date: 2016-09 Impact factor: 2.895
Authors: Philippe Robin; Ravinder K Grewal; Pierre-Yves Le Roux; Grégoire Le Gal; Pierre-Yves Salaun Journal: Thromb Res Date: 2020-01-30 Impact factor: 3.944
Authors: Fatemeh Kaghazchi; Austin J Borja; Emily C Hancin; Abhijit Bhattaru; Donald K E Detchou; Siavash Mehdizadeh Seraj; Chaitanya Rojulpote; Soren Hess; Lorenzo Nardo; Peter E Gabriel; Scott M Damrauer; Thomas J Werner; Abass Alavi; Mona-Elisabeth Revheim Journal: Am J Nucl Med Mol Imaging Date: 2021-04-15