1360P - Screening for malignancy with PET/CT scan in patients with unprovoked venous thromboembolism

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Aetiology, Epidemiology, Screening and Prevention
Staging Procedures (clinical staging)
Supportive and Palliative Care
Basic Scientific Principles
Basic Principles in the Management and Treatment (of cancer)
Presenter karim Sacre
Citation Annals of Oncology (2014) 25 (suppl_4): iv478-iv480. 10.1093/annonc/mdu351
Authors K. Sacre1, M. Chauchard2, F. Rouzet3, T. Papo2
  • 1Internal Medicine, University Paris 7, APHP, INSERM U1146, Bichat Hospital, 75018 - Paris/FR
  • 2Internal Medicine, University Paris-7, APHP, Bichat Hospital, 75018 - Paris/FR
  • 3Nuclear Medicine, University Paris-7, APHP, Bichat Hospital, 75018 - Paris/FR



To assess the value of PET/CT scan for malignancy diagnosis in patients with unprovoked venous thromboembolism (VTE)


PET/CT scan performed for malignancy screening in patients with unprovoked VTE from January 2009 to October 2013 were retrospectively reviewed. Clinical history, imaging findings including conventional total body CT-scan data, and final diagnosis were analysed.


PET/CT scan was performed for malignancy diagnosis in 68 patients with unprovoked VTE. Thirteen patients were excluded because of prior history of carcinoma (n = 5), congenital or acquired thrombophilia (n = 5), inability to confirm VTE diagnoses (n = 2) and incomplete information (n = 1). Fifty-five patients (27 females, mean age 63 + 17 years-old) were included. VTE was a first episode in 83.6% (46/55) of cases including pulmonary embolism in 38 cases. The mean follow-up was of 10 + 11months. In 28 patients (50.9%), PET/CT scan showed increased-uptake suspicious for malignancy. After additional procedures, malignancy was confirmed in 12/28 patients including pancreatic (n = 2), ovarian (n = 2), bladder (n = 1), lung (n = 1), kidney (n = 1), breast (n = 1) and gallbladder (n = 2) cancers and non-hodgkin lymphoma (n = 2). All malignancies were diagnosed at advanced stages. Six patients died during a mean follow-up of 2.9 + 2.6 months. In all cases of confirmed malignancies, conventional CT-scan had equivalent diagnostic accuracy than PET/CT scan. In 16/28 cases, the suspected diagnosis of malignancy could not be confirmed despite extensive workup including specialist visits (n = 6), testis ultrasound (n = 1), pelvis MRI (n = 1), bone MRI (n = 1), colonic endoscopy (n = 4), lung biopsy (n = 1), endometrial biopsies (n = 2), and hysterectomy (n = 1). Interestingly, CT-scan was negative in all 16 cases and, considering only CT-scan findings, no further investigations would have been scheduled. No patients with negative PET/CT scan (n = 27) were diagnosed with cancer during follow up.


Among subjects with unprovoked VTE conventional CT-scan was abnormal in all patients with cancer confirmed during follow-up. PET/CT scan imaging had no additive value. Furthermore, in 29% of patients with VTE, abnormal TEP imaging with normal CT scan led to unjustified, alarming, money-and time-consuming investigations.


All authors have declared no conflicts of interest.