Tomographie par émission de positons au F-fluorodeoxyglucose dans la mise en évidence de la maladie veineuse thromboembolique

Purpose

Association of venous thromboembolism (VTE) and inflammation reported in the literature may allow the use of FDG PET/CT in the detection of thrombotic process. Published studies remain limited and contradictory. The aim was, therefore, to evaluate the performance of FDG PET/CT for the detection of VTE.

Patients and methods

Patients included in a prospective study evaluating FDG PET/CT for the detection of malignancy in patients with idiopathic VTE were analysed (MVTEP, PHRC 2008). PET/CT images were interpreted initially without and then retrospectively with knowledge of VTE locations.

Results

Hundred and fourteen patients were included in MVTEP study from March 13th 2009 to July 1st 2010. Forty-six patients (median age: 74 years 20-87], 27 males, 19 females) were analysed. No abnormal uptake was initially reported in pulmonary vessels. The retrospective analysis of pulmonary embolism locations did not demonstrate any significant difference in FDG uptake between embolic sites and controlateral vessels (P = 0.883). Initial analysis of lower limbs vessels demonstrated sensitivity and specificity of PET/CT for deep venous thrombosis (DVT) diagnosis of 15 and 99%. The metabolic activity of DVT was significantly higher than the activity of controlateral vessels (P < 0.005) but without showing any significant SUV threshold for DVT diagnosis.

Conclusion

In conclusion, there is insufficient evidence to suggest that FDG PET/CT could be accurate in detection of VTE. These results need to be completed in a larger study with shorter delay between VTE and FDG PET/CT.