title: Performance of 18F fluoro-2-désoxy-D-glucose positron emission tomography/computed tomography for the diagnosis of venous thromboembolism.
abstract: BACKGROUND
  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.
  
  
  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.affiliation: 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.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Le Roux
authors.affiliation: 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.
authors.forename: Philippe
authors.initials: P
authors.lastname: Robin
authors.affiliation: 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.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Delluc
authors.affiliation: 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.
authors.forename: Bernard
authors.initials: B
authors.lastname: Tardy
authors.affiliation: 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.
authors.forename: Ronan
authors.initials: R
authors.lastname: Abgral
authors.affiliation: 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.
authors.forename: Francis
authors.initials: F
authors.lastname: Couturaud
authors.affiliation: Service de Médecine Nucléaire, CHU de Saint-Etienne, 42055 Saint Etienne cedex 2, France.
authors.forename: Abdelmalek
authors.initials: A
authors.lastname: Reffad
authors.affiliation: 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.
authors.forename: Grégoire
authors.initials: G
authors.lastname: Le Gal
authors.affiliation: 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.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Salaun
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D010477:Perfusion; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography; D054556:Venous Thromboembolism / Q000000981:diagnostic imaging*
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: Deep Vein Thrombosis; FDG PET/CT; Inflammation; Pulmonary embolism; Venous thromboembolism