Diagnostic Accuracy of Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in Differentiating Tumor and Bland Thrombus in Patients With Cancer: A Systematic Review and Meta-Analysis
Department
Internal Medicine
Document Type
Article
Publication Title
European Journal of Haematology
Abstract
INTRODUCTION: Differentiating tumor thrombus from bland thrombus can be challenging. This study assessed the diagnostic performance of positron emission tomography-computed tomography (PET/CT) scans in differentiating bland versus tumor thrombi in patients with cancer.
METHODS: We systematically searched for observational studies evaluating the diagnostic accuracy of PET/CT scans in differentiating tumor from bland thrombi in adult cancer patients. We included patients with suspected tumor or bland thrombus on PET/CT who underwent histopathological evaluation and/or confirmatory imaging or clinical follow-up. Sensitivity and specificity were estimated using a random-effects model. Positive and negative likelihood ratios (LR+ and LR-) and diagnostic odds ratio (DOR) were derived from the pooled estimates.
RESULTS: Five studies were included (217 patients; mean age 55.9 years). Hepatobiliary malignancies (49%) and renal tumors (24%) were the most frequent, with the renal vein, portal vein, and inferior vena cava most frequently involved. Maximum standardized uptake value (SUVmax) was significantly higher in malignant compared to bland thrombi, with reported diagnostic cutoffs ranging from 2.25 to 3.63. PET/CT scan showed diagnostic accuracy with pooled sensitivity 92.2%, specificity 94.2%, LR- 0.121, LR+ 10.919, and DOR of 91.770.
CONCLUSION: PET/CT scan may be beneficial in distinguishing tumor from bland thrombus in cancer patients.
First Page
1622
Last Page
1629
DOI
10.1111/ejh.70306
Volume
117
Issue
6
Publication Date
12-1-2026
Medical Subject Headings
Humans; Positron Emission Tomography Computed Tomography; Fluorodeoxyglucose F18; Diagnosis, Differential; Thrombosis; Neoplasms; Sensitivity and Specificity; Middle Aged; Female; Male
PubMed ID
42661593
Recommended Citation
Eltaher, B., Mahmoud, A., Balusu, K., Manshahia, P. S., Abdelhay, A., Reghis, M., Ng, S., Afzal, A., Sanfilippo, K., & Patell, R. (2026). Diagnostic Accuracy of Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in Differentiating Tumor and Bland Thrombus in Patients With Cancer: A Systematic Review and Meta-Analysis. European Journal of Haematology, 117 (6), 1622-1629. https://doi.org/10.1111/ejh.70306