EVALUATION STUDIES
JOURNAL ARTICLE
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67Ga Scintigraphy for Assessment of Disease Severity and Treatment Response in Patients With Paracoccidioidomycosis.

OBJECTIVE: The evaluation of therapy response of patients with deep mycosis is a major challenge. The aim of this study was to assess the severity of disease at admission and evaluate treatment response of patients with paracoccidioidomycosis using Ga scintigraphy.

SUBJECTS AND METHODS: Seventy-three patients with fully active disease were enrolled. A scoring system based on clinicoradiological and serological evaluation and Ga scan was devised. Pretherapy Ga score of 73 patients was compared with clinicoradiological and serological scores. A subgroup of 23 patients was followed up during treatment, and the rates of improvement of their clinicoradiological, serological, and Ga scores during treatment were compared at 3 time points (fully active phase, after clinical improvement, and clinically inactive disease).

RESULTS: The correlations between scores before therapy were statistically significant. Ga score correlated with clinical score (r = 0.47, P < 0.001). Serological score correlated with both Ga and clinical scores (r = 0.32, P = 0.006, and r = 0.25, P = 0.034, respectively). Concerning evaluation of therapy response, clinicoradiological, serological, and Ga scores decreased significantly after therapy (P < 0.001). Notably, Ga score was the single one to become negative in most patients at the end of treatment (20 of 23 patients compared with 7 on clinicoradiological evaluation and 10 on serology, P = 0.003).

CONCLUSIONS: In patients with paracoccidioidomycosis, pretherapy Ga scintigraphy correlates with disease severity. Serial Ga scans seem to be helpful in evaluating the response to therapy.

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