Imaging Characteristics of a Novel Technetium Tc 99m–Labeled Platelet Glycoprotein IIb/IIIa Receptor Antagonist in Patients With Acute Deep Vein Thrombosis or a History of Deep Vein Thrombosis

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Abstract
CLINICAL DIAGNOSIS of deep vein thrombosis (DVT) alone is inaccurate.1-4 Therefore, accurate objective testing is required to avoid incorrectly concluding that DVT is absent and placing the patient at high risk of potentially fatal pulmonary embolism5 or misdiagnosing DVT and exposing the patient unnecessarily to the risks of anticoagulant therapy.5-7 Although several diagnostic algorithms for suspected first DVT have been validated,8 the diagnosis of recurrent DVT continues to pose a problem. Venous compression ultrasonography (CUS) is the most widely used noninvasive test for the investigation of a suspected first DVT, with noncompressibility of the common femoral vein or popliteal vein considered diagnostic of acute DVT in symptomatic patients.8 However, the diagnosis of recurrent DVT by means of CUS is problematic because persistent abnormalities are present in approximately 80% of patients 3 months and 50% of patients 1 year after proximal DVT.9-12 Therefore, when a patient with suspected recurrence has a noncompressible venous segment, it can be difficult to determine whether this represents new disease or a residual abnormality from previous DVT. Similarly, persistent abnormalities as well as nonfilling segments in patients with previous DVT often make contrast venography, the reference standard test for a suspected first episode of DVT, nondiagnostic.13 Although the combination of impedance plethysmography14 and radioactive fibrinogen uptake scanning13 has been validated for the diagnosis of recurrence, impedance plethysmography is obsolete and radioactive fibrinogen uptake scanning is no longer available. As a result, there is a clear need for a test (or combination of tests) that is able to accurately diagnose recurrent DVT.