Noninvasive imaging for LE DVT has advanced remarkably in the past decade. Currently, IPG and ultrasound techniques (RTU and DS) have been proven to be quick, accurate, relatively inexpensive, and widely available methods for detecting proximal LE DVT and can be used as the initial diagnostic studies in many settings. Color-flow Doppler ultrasound studies may be more accurate than other ultrasound techniques in diagnosing calf DVT and in differentiating acute from chronic LE DVTs, though this bears further review. Many concerns remain regarding noninvasive LE DVT imaging, including: The accuracy of the above studies in nonreferral centers. The need for and optimal frequency of follow-up studies to detect clots that propagate proximally. The optimal noninvasive techniques for imaging in the setting of recurrent DVT and other specialized settings (e.g., high-risk patients).
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