FDG PET/CT Imaging in Mucormycosis: A Novel Approach for Early Detection and Disease Monitoring

To evaluate the role of FDG PET/CT in diagnosing and monitoring rhinocerebral mucormycosis (RCM) and its added value over conventional imaging.

We conducted a prospective observational study of 47 adults with biopsy-confirmed rhinocerebral mucormycosis between July 2022 and September 2024. All patients underwent FDG PET/CT, and findings were compared with MRI/CT and correlated with microbiological or histopathologic results. PET/CT was used to assess disease extent, identify residual or recurrent disease, and monitor treatment response.

Of the 47 patients (43 men, 4 women; mean age 49.4 ± 12.2 y), 3 were imaged preoperatively and 44 postoperatively. PET/CT detected metabolically active disease in 35 patients, including 6 (12.8%) with lesions not well visualized on MRI/CT. Preoperative SUVmax was higher than postoperative (8.12 vs 6.12), reflecting disease burden reduction after surgery. PET/CT confirmed disease resolution in 12 patients who remained recurrence-free on follow-up. In 32 patients, PET/CT identified residual or recurrent disease, influencing further surgical and medical management. Representative images demonstrate PET/CT detection of active lesions missed on MRI/CT.

FDG PET/CT delineates disease extent, guides therapeutic decisions, and confirms treatment response. Incorporating PET/CT into routine clinical management may improve outcomes by enabling timely, targeted interventions.