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18F-FDG PET-CT in the diagnosis of tumor thrombus: can it be differentiated from benign thrombus?
MedLine Citation:
PMID:  21799368     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: The correct diagnosis of tumor thrombosis and its differentiation from benign thrombus can change patient management and prevent unnecessary anticoagulation treatment. This study was aimed at evaluating the role of fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) in the diagnosis of tumor thrombosis, and its differentiation from benign thromboembolism.
METHODS: We conducted a retrospective review of FDG PET-CT scans of patients who underwent the study for staging/restaging of a known malignancy and had FDG-avid thrombosis. Maximum standardized uptake value (SUVmax) of the thrombus, SUVmax of tumor (if any), and SUVmax of mediastinal blood pool were calculated. PET-CT results were confirmed with clinical follow-up, structural imaging, and histopathology when available.
RESULTS: A total of 24 patients (15 male and nine female) with a mean age of 43.8 years (range: 3-72 years; median: 47.5 years) were evaluated. On the basis of structural imaging and clinical follow-up, 10 patients had benign and 14 patients had tumor thrombosis. On FDG PET-CT, uptake in the thrombus was linear in 18 patients and focal in six patients. The most common site of thrombosis was the inferior vena cava. The mean SUVmax was 3.2 (range: 2.3-4.6; median: 3.3) in the benign thrombosis group and was 6.0 (range: 2.3-13.8; median: 3.3) in the tumor thrombosis group. The difference in SUVmax was significant (P=0.013). On receiver operating characteristic analysis, a cut-off SUVmax of 3.63 (sensitivity: 71.4% and specificity: 90%) was obtained to differentiate tumor thrombus from benign thromboembolism. In six patients, FDG PET-CT detected occult vascular thrombosis.
CONCLUSION: FDG PET-CT can detect active tumor thrombosis and is helpful in differentiating it from benign thrombus.
Authors:
Punit Sharma; Rakesh Kumar; Sunil Jeph; Sellam Karunanithi; Niraj Naswa; Arun Gupta; Arun Malhotra
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Nuclear medicine communications     Volume:  32     ISSN:  1473-5628     ISO Abbreviation:  Nucl Med Commun     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-07-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8201017     Medline TA:  Nucl Med Commun     Country:  England    
Other Details:
Languages:  eng     Pagination:  782-8     Citation Subset:  IM    
Affiliation:
Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
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