title: Tumor thrombus: ancillary findings on FDG PET/CT in an oncologic population.
abstract: OBJECTIVE
  Thrombosis in cancer may manifest itself as venous thromboembolic disease or tumor thrombosis (TT). We present our experience with incidentally detected TT on FDG PET/CT in 21 oncologic patients.
  
  
  METHODS
  We retrospectively reviewed all FDG PET/CT examinations during a 5-year period at the Army Hospital Research and Referral in New Delhi, India, and included all oncology cases with FDG-avid thrombosis in the report. The diagnosis of TT was based on FDG-avid solid masses inside the vessels in patients with known malignancy. The SUVmax was calculated.
  
  
  RESULTS
  Twenty-one patients were included; the most common malignancies were renal cell carcinoma (n=6), hepatocellular carcinoma (n=3), and lung cancer (n=3). Indication for the scan was initial staging (n=15) and suspected recurrence (n=6). Several vessels were affected, the most common was the inferior vena cava (n=14), but most other major branches of the venous vasculature was represented, and some patients had thrombi in several vessels. FDG uptake was linear in 7 patients, linear with a dilated vessel in 6 patients, and focal in 7 patients. The mean SUVmax of the primary tumors was 10.3 (range, 2.6-31.2; median, 6.9), and the mean SUVmax of the thrombi was 7.85 (range, 1.7-23.2; median, 6.1). All but 2 patients had additional FDG-avid foci besides the thrombus.
  
  
  CONCLUSIONS
  This study supports results from other smaller studies regarding the usefulness of FDG PET/CT in TT and corroborates the hypothesis that the SUVmax and the patterns of FDG uptake can be helpful for differentiating BT from TT in oncological patients.
authors.affiliation: From the *Department of Nuclear Medicine, Army Hospital Research and Referral, New Delhi, India; †Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark; and ‡Division of Nuclear Medicine, University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA.
authors.forename: Mudalsha
authors.initials: M
authors.lastname: Ravina
authors.forename: Søren
authors.initials: S
authors.lastname: Hess
authors.forename: Mahesh Singh
authors.initials: MS
authors.lastname: Chauhan
authors.forename: Mattakorottu Joseph
authors.initials: MJ
authors.lastname: Jacob
authors.forename: Abass
authors.initials: A
authors.lastname: Alavi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000000981:diagnostic imaging; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000000981:diagnostic imaging; D002648:Child; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009369:Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D011169:Portal Vein / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D014680:Veins / Q000000981:diagnostic imaging; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging*; D054556:Venous Thromboembolism / Q000150:complications / Q000000981:diagnostic imaging*; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18