Wednesday, December 4 | 3:40 p.m.-3:50 p.m. | SSM24-05 | Room E450B
Patients at high risk for thrombosis can benefit from screening ultrasound, according to researchers at the University of Rochester Medical Center.In this afternoon scientific session, Dr. Deborah Rubens will present findings from a study that evaluated the benefits of screening for thrombosis in a cohort of asymptomatic cancer patients starting outpatient chemotherapy.
Rubens' team evaluated 35 patients with a baseline ultrasound and a follow-up exam every four weeks for up to 16 weeks. In addition, some patients had CT scans for chemotherapy restaging purposes, and these exams were evaluated for venous thromboembolism. Patients were assessed for risk using a risk model developed by study co-author Dr. Alok Khorana.
Of the 35 patients, eight (23%) had venous thromboembolism, five (14%) had deep vein thrombosis, one (3%) had pulmonary embolism, and two (6%) had both deep vein thrombosis and pulmonary embolism. Of the five patients who had deep vein thrombosis, two had clots in their calf, two had calf and thigh clots, and one had an upper extremity clot.
For patients with a high risk score for venous thromboembolism, clinicians should consider screening ultrasound for asymptomatic clots, especially in the calf, the researchers concluded.



















![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&fit=crop&h=112&q=70&w=112)