PET/CT imaging and human papilloma virus-positive oropharyngeal squamous cell cancer: evolving clinical imaging paradigm.

Journal Article (Journal Article;Review)

Human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) represents an emerging disease that differs from HPV-negative OPSCC in natural history and prognosis. Contrast-enhanced PET/CT is essential to accurately stage the primary site when there are smaller tumors; neck nodal metastases, which tend to have a more cystic component; and distant metastases that manifest in unusual sites (disseminating phenotype) such as bones and other solid organs, including brain. Metastases tend to appear later in the disease course during follow-up for HPV-positive OPSCC than for HPV-negative OPSCC. Because HPV-positive OPSCC patients have a better clinical outcome, there is a need for treatment deintensification to spare the patient from treatment-related toxicities. (18)F-FDG PET/CT would play a role in monitoring patients with deintensified treatments to ensure that no adverse outcome is introduced. The better prognosis and outcome of HPV-positive OPSCC patients would warrant imaging follow-up that is less intense but continues longer because of the manifestation of distant metastases later in the disease course and at unusual sites. All these clinical paradigms facilitate a definite role for PET/CT imaging in the management of HPV-positive OPSCC.

Full Text

Duke Authors

Cited Authors

  • Subramaniam, RM; Alluri, KC; Tahari, AK; Aygun, N; Quon, H

Published Date

  • March 2014

Published In

Volume / Issue

  • 55 / 3

Start / End Page

  • 431 - 438

PubMed ID

  • 24408893

Electronic International Standard Serial Number (EISSN)

  • 1535-5667

Digital Object Identifier (DOI)

  • 10.2967/jnumed.113.125542

Language

  • eng

Conference Location

  • United States