# Evaluating the Characteristics of the Totally Implantable Venous Access Device in Cancer Patients Using Fluorodeoxyglucose-PET/CT in the Absence of Suspected Catheter-Related Infections

## TL;DR

This study examines FDG-PET/CT imaging features of a venous access device in cancer patients to understand increased FDG accumulation patterns.

## Contribution

The study identifies patterns of FDG accumulation associated with TIVAD placement and suggests possible underlying causes.

## Key findings

- Increased FDG accumulation was observed in 8.3% of cases at the vein of catheter penetration.
- Accumulation was only seen with the subclavian approach and not with other approaches.
- Most accumulations occurred in patients with an indwelling time of more than one month.

## Abstract

Purpose: This study evaluated the fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) imaging features associated with the totally implantable venous access device (TIVAD) in cancer patients.

Methods: We conducted a retrospective single-institution review of TIVAD placements between January 2016 and December 2020. Among these, we identified cases where FDG-PET/CT was performed to monitor malignant tumors after TIVAD placement. Increased accumulation was evaluated based on the site, TIVAD approach, and indwelling time.

Results: In total, 145 TIVAD placements were identified in 144 patients. The median number of FDG-PET/CT examinations was two (range: 1-14). Sites of increased accumulation were found in the vein of catheter penetration (8.3%) and port (1.4%). Increased accumulations were observed only with the subclavian approach. In patients with an indwelling time > 1 month, all accumulations were observed in the vein of catheter penetration (7.9%).

Conclusion: Increased FDG accumulation associated with the TIVAD is not uncommon. A small thrombus with some reactive processes at the vein penetration site may be responsible for the increased accumulation.