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Radiologists encouraged to look beyond cancer for clinically unseen diseases

August 15, 2007

Radiologists can diagnose venous thromboembolic disease (VTED) in cancer patients earlier by looking more carefully at CT scans of the thorax, abdomen, and pelvis which are regularly done to determine the extent or stage of the cancer, according to a recent study conducted by radiologists at the University College Hospital in Galway, Ireland.

Venous thromboembolic disease can be fatal if left untreated. The study focused on pulmonary embolism (PE), inferior vena cava (IVC), and iliac and iliofemoral deep venous thromboses (DVTs) in oncology patients.

"We'd noticed a number of clinically unsuspected deep venous thrombosis and pulmonary emboli on staging CT thorax, abdomen and pelvis examinations which goes unnoticed," said Carmel Cronin, MD, lead author of the study. "When we do a CT to stage the cancer we can see both the pulmonary arterial system and the pelvic and lower extremity venous system," she said.

The study included 736 patients ranging from 20 to 79 years of age. According to the study, 23 patients had unsuspected iliofemoral DVT and four had common iliac vein involvement. The study also showed that 13 patients had an unsuspected pulmonary embolism.

"We were surprised by the results, said Dr. Cronin. "However, as outlined in other literature, the true prevalence of venous thromboembolic disease is underestimated as many are clinically unapparent. Venous thrombosis is estimated to be diagnosed in less than 40% of those with a concomitant venous thrombosis and malignancy," she said.

American Roentgen Ray Society