Commentary (Meissner): Diagnosis of Venous Thromboembolic Disease in Cancer Patients

The diagnosis of venous thromboembolism on the basis of clinical signs and symptoms is notoriously inaccurate and, therefore, mandates confirmatory diagnostic testing. Unfortunately, all diagnostic tests for deep venous thrombosis (DVT) and pulmonary embolism have clinical or practical limitations. Contrast venography and pulmonary arteriography are usually regarded as the reference standards for the diagnosis of DVT and pulmonary embolism, respectively. However, even contrast venography may be impossible to perform in 9% to 14% of patients, may fail to visualize 10% to 30% of venous segments, and may be associated with postvenography thrombosis in up to 8% of patients.[1]