¹⁸F-fluorodeoxyglucose positron emission tomography for the initial evaluation and monitoring of therapeutic response in bilateral adrenal histoplasmosis

18F-fluorodeoxyglucose positron emission tomography (FDG-PET) of a 74-year-old man showed high FDG uptake in bilateral adrenal histoplasmosis. Four months after the administration of an appropriate antifungal treatment, we observed a significant decrease in FDG uptake into the lesions, with a 40% reduction in activity (maximal standardized uptake value). This imaging result indicated partial resolution of the disease and was consistent with clinical outcome. Our study results suggest that FDG-PET is a useful modality for initial whole-body evaluation, selection of an appropriate antifungal treatment regimen, and monitoring of therapeutic response in bilateral adrenal histoplasmosis.