Imaging thrombus in cancer patients with FDG PET-CT

The incidence of thrombosis in patients with underlying primary malignancy is high. The thrombus may be the more common venous thromboembolism (VTE) or the rare tumour thrombus. VTE is a common entity in cancer patients and is managed with anticoagulant therapy, while tumour thrombosis requires aggressive multimodality management. Conventional imaging modalities, including ultrasonography, venography, contrast-enhanced computed tomography, and magnetic resonance imaging, are used routinely in such cases. With its increasing use in oncology, more and more such thrombi are encountered on 18F-fluorodeoxyglucose (FDG) positron emission tomography- computed tomography (PET-CT). Accurate characterisation of these lesions is of utmost importance owing to complementary functional information which it provides. FDG PET-CT has been found to be helpful in this context. This pictorial review discusses and illustrates the imaging features of thrombosis on FDG PET-CT.