{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:02:59Z","timestamp":1791396179782,"version":"4.3.3"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001807","name":"S\u00e3o Paulo State Research Council","doi-asserted-by":"publisher","award":["2021\/03421-3"],"award-info":[{"award-number":["2021\/03421-3"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"S\u00e3o Paulo State Research Council","doi-asserted-by":"publisher","award":["2021\/10265-8"],"award-info":[{"award-number":["2021\/10265-8"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Paracoccidioidomycosis (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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty-four patients with confirmed PCM (treatment-na\u00efve 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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PET\/CT detected more than twice as many lesions as conventional evaluation (150 vs 62; mean 4.4 \u00b1 1.6 vs 1.8 \u00b1 0.9 affected organ systems per patient), with statistically significant superiority for lymph node, pulmonary, and adrenal involvement (McNemar's test, P &amp;lt; .05). PET\/CT reclassified 97% of patients as multifocal versus 59% by conventional staging and produced a significant unidirectional shift toward higher severity\u2014the 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-na\u00efve patients (P &amp;lt; .05). Quantitative PET parameters correlated with serological titers and inflammatory markers (P &amp;lt; .05), and PET\/CT detected four times as many sites as gallium-67 scintigraphy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>18F-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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag372","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:22:38Z","timestamp":1781612558000},"page":"e515-e525","source":"Crossref","is-referenced-by-count":0,"title":["FDG-PET\/CT Demonstrates Superior Detection of Multiorgan Involvement in Paracoccidioidomycosis Compared With Conventional Staging"],"prefix":"10.1093","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2909-279X","authenticated-orcid":false,"given":"Pricila G","family":"Cunha","sequence":"first","affiliation":[{"name":"Division of Nuclear Medicine, Department of Radiology and Oncology, School of Medical Sciences, University of Campinas (UNICAMP) , Campinas 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