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<p>Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), poses a significant clinical challenge due to its complex pathophysiology and diagnostic difficulties. Recent advances in 18&#xa0;F-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) have shown promise in assessing thrombus metabolic activity. Our systematic review and meta-analysis evaluated the utility of FDG-PET/CT in diagnosing VTE and differentiating thrombus types using standardized uptake values (SUVmax). A total of fourteen studies with a total of 655 participants met our inclusion criteria. Data were extracted for diagnostic performance, focusing on mean SUVmax for TT (Tumor Thrombus) and BT (Bland Thrombus). Pooled estimates were calculated using the DerSimonian–Laird random-effects model, and heterogeneity was assessed via the Higgins I² statistic. The pooled mean SUVmax for TT, reported in five studies, was 6.24 (95% CI: 5.49–6.99, <i>p</i> &lt; 0.05) with negligible heterogeneity, whereas BT, reported in ten studies, showed a pooled mean SUVmax of 2.11 (95% CI: 1.77–2.45) with moderate heterogeneity. The standardized mean difference (SMD) between TT and BT was 3.73 (95% CI: 2.90–4.55), indicating significantly higher metabolic activity in tumor thrombi. In conclusion, FDG-PET/CT appears to be a promising noninvasive tool for distinguishing TT from BT and assessing thrombus age, thereby potentially guiding the clinical management of VTE. Nonetheless, challenges such as cost, accessibility, and optimal imaging timing remain. Future prospective studies are warranted to validate these findings and establish FDG-PET/CT’s role in routine diagnostic pathways.</p>

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The role of PET/CT in diagnosing and differentiating tumor vs. bland thrombi: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年5月7日

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  • Mohammad Hazique,
  • Sirish Raj Pandey,
  • Sujan Niraula,
  • Amit Barua,
  • Yasemin Bahar,
  • Ryan C. Denley

摘要

Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), poses a significant clinical challenge due to its complex pathophysiology and diagnostic difficulties. Recent advances in 18 F-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) have shown promise in assessing thrombus metabolic activity. Our systematic review and meta-analysis evaluated the utility of FDG-PET/CT in diagnosing VTE and differentiating thrombus types using standardized uptake values (SUVmax). A total of fourteen studies with a total of 655 participants met our inclusion criteria. Data were extracted for diagnostic performance, focusing on mean SUVmax for TT (Tumor Thrombus) and BT (Bland Thrombus). Pooled estimates were calculated using the DerSimonian–Laird random-effects model, and heterogeneity was assessed via the Higgins I² statistic. The pooled mean SUVmax for TT, reported in five studies, was 6.24 (95% CI: 5.49–6.99, p < 0.05) with negligible heterogeneity, whereas BT, reported in ten studies, showed a pooled mean SUVmax of 2.11 (95% CI: 1.77–2.45) with moderate heterogeneity. The standardized mean difference (SMD) between TT and BT was 3.73 (95% CI: 2.90–4.55), indicating significantly higher metabolic activity in tumor thrombi. In conclusion, FDG-PET/CT appears to be a promising noninvasive tool for distinguishing TT from BT and assessing thrombus age, thereby potentially guiding the clinical management of VTE. Nonetheless, challenges such as cost, accessibility, and optimal imaging timing remain. Future prospective studies are warranted to validate these findings and establish FDG-PET/CT’s role in routine diagnostic pathways.