Detection of lower limb deep vein thrombosis: Comparison between radionuclide venography and venous ultrasonography

Deep vein thrombosis (DVT) is a serious medical condition that needs prompt diagnosis and treatment. The invasive gold standard contrast venography has largely been replaced by venous ultrasonography which is currently the imaging modality of choice for DVT diagnosis. Radionuclide venography (RNV) i...

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Main Authors: Daris Theerakulpisut, Nantaporn Wongsurawat, Charoonsak Somboonporn
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2018-01-01
Series:World Journal of Nuclear Medicine
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.4103/wjnm.WJNM_13_17
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author Daris Theerakulpisut
Nantaporn Wongsurawat
Charoonsak Somboonporn
author_facet Daris Theerakulpisut
Nantaporn Wongsurawat
Charoonsak Somboonporn
author_sort Daris Theerakulpisut
collection DOAJ
description Deep vein thrombosis (DVT) is a serious medical condition that needs prompt diagnosis and treatment. The invasive gold standard contrast venography has largely been replaced by venous ultrasonography which is currently the imaging modality of choice for DVT diagnosis. Radionuclide venography (RNV) is an alternative test for DVT, but a few studies have directly compared RNV with venous ultrasonography. This study aims to determine the agreement between RNV and venous ultrasonography for diagnosis of DVT and to determine the predictive value of different RNV findings for the prediction of DVT as detected by venous ultrasonography. Imaging results from patients who underwent both RNV and venous ultrasonography for suspected DVT no more than 1 week apart were reviewed. Results from both modalities were compared to determine inter-modality agreement. A total of 121 venous segments from 102 lower limbs of 75 patients could be compared. The prevalence of DVT as detected by venous ultrasonography was 39%. RNV and venous ultrasonography had moderate agreement (73.6% agreement, κ =0.48, P < 0.0001). The absence of radiotracer activity from a deep venous segment had a positive predictive value (PPV) of 100% for DVT. Other findings such as isolated great saphenous vein activity had a lower PPV. The negative predictive value of RNV is 97.5% with only one patient out of forty with normal RNV found to have DVT by venous ultrasonography, which suggests that DVT can virtually be excluded in patients with normal RNV.
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spelling doaj-art-27dba45ef2a147ef9c0eff0003a0fee72025-08-20T02:54:43ZengThieme Medical and Scientific Publishers Pvt. Ltd.World Journal of Nuclear Medicine1450-11471607-33122018-01-011701273310.4103/wjnm.WJNM_13_17Detection of lower limb deep vein thrombosis: Comparison between radionuclide venography and venous ultrasonographyDaris Theerakulpisut0Nantaporn Wongsurawat1Charoonsak Somboonporn2Department of Radiology, Division of Nuclear Medicine, Faculty of Medicine, Khon Kaen University, Khon KaenDepartment of Radiology, Division of Nuclear Medicine, Faculty of Medicine, Khon Kaen University, Khon KaenDepartment of Radiology, Division of Nuclear Medicine, Faculty of Medicine, Khon Kaen University, Khon KaenDeep vein thrombosis (DVT) is a serious medical condition that needs prompt diagnosis and treatment. The invasive gold standard contrast venography has largely been replaced by venous ultrasonography which is currently the imaging modality of choice for DVT diagnosis. Radionuclide venography (RNV) is an alternative test for DVT, but a few studies have directly compared RNV with venous ultrasonography. This study aims to determine the agreement between RNV and venous ultrasonography for diagnosis of DVT and to determine the predictive value of different RNV findings for the prediction of DVT as detected by venous ultrasonography. Imaging results from patients who underwent both RNV and venous ultrasonography for suspected DVT no more than 1 week apart were reviewed. Results from both modalities were compared to determine inter-modality agreement. A total of 121 venous segments from 102 lower limbs of 75 patients could be compared. The prevalence of DVT as detected by venous ultrasonography was 39%. RNV and venous ultrasonography had moderate agreement (73.6% agreement, κ =0.48, P < 0.0001). The absence of radiotracer activity from a deep venous segment had a positive predictive value (PPV) of 100% for DVT. Other findings such as isolated great saphenous vein activity had a lower PPV. The negative predictive value of RNV is 97.5% with only one patient out of forty with normal RNV found to have DVT by venous ultrasonography, which suggests that DVT can virtually be excluded in patients with normal RNV.http://www.thieme-connect.de/DOI/DOI?10.4103/wjnm.WJNM_13_17deep vein thrombosisdoppler ultrasonographyradionuclide imagingradionuclide venographyvenous thrombosis
spellingShingle Daris Theerakulpisut
Nantaporn Wongsurawat
Charoonsak Somboonporn
Detection of lower limb deep vein thrombosis: Comparison between radionuclide venography and venous ultrasonography
World Journal of Nuclear Medicine
deep vein thrombosis
doppler ultrasonography
radionuclide imaging
radionuclide venography
venous thrombosis
title Detection of lower limb deep vein thrombosis: Comparison between radionuclide venography and venous ultrasonography
title_full Detection of lower limb deep vein thrombosis: Comparison between radionuclide venography and venous ultrasonography
title_fullStr Detection of lower limb deep vein thrombosis: Comparison between radionuclide venography and venous ultrasonography
title_full_unstemmed Detection of lower limb deep vein thrombosis: Comparison between radionuclide venography and venous ultrasonography
title_short Detection of lower limb deep vein thrombosis: Comparison between radionuclide venography and venous ultrasonography
title_sort detection of lower limb deep vein thrombosis comparison between radionuclide venography and venous ultrasonography
topic deep vein thrombosis
doppler ultrasonography
radionuclide imaging
radionuclide venography
venous thrombosis
url http://www.thieme-connect.de/DOI/DOI?10.4103/wjnm.WJNM_13_17
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AT nantapornwongsurawat detectionoflowerlimbdeepveinthrombosiscomparisonbetweenradionuclidevenographyandvenousultrasonography
AT charoonsaksomboonporn detectionoflowerlimbdeepveinthrombosiscomparisonbetweenradionuclidevenographyandvenousultrasonography