Prospective Comparison of the Diagnostic Potential of Real-Time PCR, Double-Sandwich Enzyme-Linked Immunosorbent Assay for Galactomannan, and a (1→3)-β-d-Glucan Test in Weekly Screening for Invasive Aspergillosis in Patients with Hematological Disorders

Number of days from when GM assays become positive to the onset of treatment, using a threshold of 0.6 O.D.I. by method II (solid arrowheads) or 1.0 O.D.I. by method II (open arrowheads), or positive findings on CT. Open triangles indicate the date of positive culture, and solid triangles indicate when the histopathological diagnosis was made (Px, biopsy; Ax, autopsy). The values in parentheses indicate the number of days after the onset of treatment. For example, for episode 11, CT showed specific findings 50 days after the onset of treatment and the GM assay become positive 2 days before treatment. Episode numbers correspond to those in Table 2. Episodes whose GM assays did not reach the threshold are not shown. For episodes 2 and 9, a CT scan was not performed, and for episodes 7, 8, 10, 17, 19, 21, and 22, the CT findings were nonspecific and could not be used for decision-making. Each treatment was started at the discretion of the physician, taking into account various prices of clinical information, including CT findings and the results of GM assays. For Episode 8, IA was not suspected and no antifungal agent was administered. Therefore, the date of death was used instead of the date of treatment onset.