ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2026
FDG-PET/CT Demonstrates Superior Detection of Multiorgan Involvement in Paracoccidioidomycosis Compared With Conventional Staging.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundParacoccidioidomycosis (PCM) is a neglected systemic mycosis in which accurate staging is critical but challenging with conventional methods. This study evaluated 18F-FDG PET/CT compared with standard evaluation for PCM staging and assessed its impact on disease severity classification.
methodsThirty-four patients with confirmed PCM (treatment-naïve or with suspected treatment failure) underwent conventional staging and whole-body 18F-FDG PET/CT. Disease severity was classified as mild, moderate, or severe. PET/CT images were analyzed qualitatively and quantitatively (SUVmax, TMLV, TLG).
resultsPET/CT detected more than twice as many lesions as conventional evaluation (150 vs 62; mean 4.4 ± 1.6 vs 1.8 ± 0.9 affected organ systems per patient), with statistically significant superiority for lymph node, pulmonary, and adrenal involvement (McNemar's test, P < .05). PET/CT reclassified 97% of patients as multifocal versus 59% by conventional staging and produced a significant unidirectional shift toward higher severity-the proportion classified as severe increased from 70.6% to 91.2% (P = .016). Patients with suspected treatment failure showed significantly lower TMLV and TLG than treatment-naïve patients (P < .05). Quantitative PET parameters correlated with serological titers and inflammatory markers (P < .05), and PET/CT detected four times as many sites as gallium-67 scintigraphy.
conclusions18F-FDG PET/CT systematically reveals greater disease burden than conventional evaluation in PCM, reclassifying most patients toward higher severity with direct implications for treatment duration and follow-up. Where available, it should be considered an important complementary modality for initial disease assessment.
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