From the Departments of *Nuclear Medicine, †Respiratory Medicine, and ‡Acute Medicine, Odense University Hospital, Odense, Denmark; and §Division of Nuclear Medicine, University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA.
Clin Nucl Med. 2015 Jan;40(1):e23-6. doi: 10.1097/RLU.0000000000000453.
In recent years, several case reports have described venous thromboembolism (VTE) on FDG PET/CT. In this short communication, we present results from a proof-of-concept pilot study aimed at providing some preliminary data on the efficacy of FDG PET/CT in prospective patients with suspected VTE.
Fifteen patients with suspected deep venous thrombosis (DVT) and/or pulmonary embolism (PE) were included prospectively and underwent a whole-body FDG PET/CT. Patients were divided into 4 groups as follows: DVT+ (DVT proven by high clinical suspicion and positive compression ultrasound), DVT- (DVT ruled out by low clinical suspicion and negative compression ultrasound), PE+ (PE proven by high clinical suspicion and positive lung scintigraphy), and PE- (PE ruled out by low clinical suspicion and normal lung scintigraphy). Images were interpreted visually by 2 experienced nuclear medicine physicians independently and without knowledge of other imaging results.
Seven DVT+, 6 DVT-, 6 PE+, and 1 PE- were included. Five patients were suspected of both DVT and PE. FDG PET/CT correctly diagnosed the presence or lack of DVT in all patients, whereas results are more ambiguous in PE with only 2 of 6 PE patients showing FDG avidity. The readers agreed in all cases.
Although further studies are warranted for further clarification, our preliminary data substantiate that FDG PET/CT is a viable modality for assessing VTE, at least for DVT. We believe our results add positively to the limited data on this subject and are promising enough to warrant further larger series.
近年来，已有数份病例报告描述了 FDG PET/CT 中的静脉血栓栓塞症（VTE）。在本次简短的交流中，我们呈现了一项概念验证性前瞻性研究的结果，旨在为疑似 VTE 患者的 FDG PET/CT 疗效提供初步数据。
15 例疑似深静脉血栓形成（DVT）和/或肺栓塞（PE）的患者前瞻性纳入并接受全身 FDG PET/CT 检查。患者分为 4 组：DVT+（DVT 经高临床疑诊和阳性压缩超声证实）、DVT-（DVT 经低临床疑诊和阴性压缩超声排除）、PE+（PE 经高临床疑诊和阳性肺闪烁扫描证实）和 PE-（PE 经低临床疑诊和正常肺闪烁扫描排除）。图像由 2 名经验丰富的核医学医师独立进行视觉解读，且不了解其他影像学结果。
7 例 DVT+、6 例 DVT-、6 例 PE+和 1 例 PE-纳入。5 例患者同时怀疑 DVT 和 PE。FDG PET/CT 在所有患者中正确诊断了 DVT 的存在或缺失，而在仅 2 例 PE 患者中结果对于 PE 则较为模糊，这些患者显示 FDG 摄取。读者在所有病例中均达成一致。
尽管还需要进一步的研究来进一步澄清，但我们的初步数据证实 FDG PET/CT 是评估 VTE 的可行方法，至少对于 DVT 是如此。我们认为我们的结果对这一主题的有限数据有积极的补充作用，并且非常有希望值得进一步开展更大系列的研究。
