Clinical Nuclear Medicine

Skip Navigation LinksHome > December 2012 - Volume 37 - Issue 12 > 18F-FDG PET in the Evaluation of Acuity of Deep Vein Thrombo...
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Clinical Nuclear Medicine:
doi: 10.1097/RLU.0b013e3182638934
Original Articles

18F-FDG PET in the Evaluation of Acuity of Deep Vein Thrombosis

Rondina, Matthew T. MD*†; Lam, Uyen T. BS; Pendleton, Robert C. MD*; Kraiss, Larry W. MD§; Wanner, Nathan MD*; Zimmerman, Guy A. MD†¶; Hoffman, John M. MD∥**††; Hanrahan, Christopher MD, PhD††; Boucher, Kenneth PhD∥**; Christian, Paul E. BS, CNMT; Butterfield, Regan I. BS, CNMT; Morton, Kathryn A. MD††

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Purpose: 18F-FDG PET has been used for vascular disease, but its role in deep vein thrombosis (DVT) remains prospectively unexplored.

Patients and Methods: Whole-body 18F-FDG PET/CT scans were performed in patients 1 to 10 weeks after onset of symptomatic DVT (n = 12) and in control subjects without DVT (n = 24). The metabolic activity (SUVmax) of thrombosed and contralateral nonthrombosed vein segments was determined. The sensitivity and specificity of 18F-FDG PET/CT for the diagnosis of DVT were determined by receiver operating characteristic curve analyses. In 2 patients with DVT, changes in the metabolic activity of thrombosed vein segments in serial 18F-FDG PET scans.

Results: The metabolic activity in thrombosed veins [SUVmax, 2.41 (0.75)] was visually appreciable and significantly higher than in nonthrombosed veins in either the contralateral extremity of patients with DVT [SUVmax, 1.09 (0.25), P = 0.007] or control subjects [1.21 (0.22), P < 0.001]. The area under the receiver operating characteristic curve for SUVmax was 0.9773 (P < 0.001), indicating excellent accuracy. An SUVmax threshold of greater than 1.645 was 87.5% sensitive and 100% specific for DVT. Metabolic activity in thrombosed veins correlated significantly with time from DVT symptom onset (decrease in SUVmax of 0.02/d, P < 0.05). Best-fit-line analyses suggested that approximately 84 to 91 days after acute DVT, the maximum metabolic activity of thrombosed veins would return to normal levels.

Conclusions: 18F-FDG PET/CT is accurate for detecting acute symptomatic, proximal DVT. Metabolic activity in thrombosed veins decreases with time, suggesting that 18F-FDG PET may be helpful in assessing the age of the clot.

© 2012 Lippincott Williams & Wilkins, Inc.


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