Diagnosis of Deep Septic Thrombophlebitis in Cancer Patients by Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography Scanning: A Preliminary Report
Marisa Miceli, Rola Atoui, Ronald Walker, Tahsine Mahfouz, Nadeem Mirza, Jose Diaz, Guido Tricot, Bart Barlogie, and Elias Anaissie
Journal of Clinical Oncology 22:1949-1956, May 2004

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Purpose
To determine the role of the fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) scan in the diagnosis and management of deep septic thrombophlebitis (STP).

Patients and Methods
We conducted a prospective observational evaluation of FDG-PET in patients with cancer and suspected STP. Retrospective evaluation of patients with cancer and deep venous thrombosis (DVT) who underwent FDG-PET and extremity duplex scan (DS) was also performed.

Results
Strong venous uptake was observed in FDG-PET of nine STP episodes versus 0 of 27 DVT episodes (P < .001). FDG-PET identified central vein STP in five patients, whereas DS and venography were negative in five and two of these patients, respectively. FDG-PET diagnosis of STP resulted in therapeutic changes in all patients. In four patients, follow-up FDG-PET confirmed resolution.

Conclusion
In cancer patients, FDG-PET identifies STP even in areas not optimally visualized by DS or venography, distinguishes STP from DVT, and leads to significant therapeutic changes.

• Introduction
• Patients and Methods
  • Definitions
  • Patient Groups
  • FDG-PET Imaging
  • Vascular Ultrasonography
  • Patient Data
  • Statistical Methods
• Results
• Discussion
• References

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