Association of oropharyngeal cancer HPV status with diffusion-weighted MR imaging and FDG-PET parameters

Background

Human papilloma virus (HPV) infection is an important risk factor in oropharyngeal cancer. Several studies have analyzed the association of tumoral HPV status and different imaging parameters in FDG-PET/CT and magnetic resonance (MR) diffusion-weighted imaging (DWI), with contradictory findings. In this retrospective study, the influence of HPV-status on different parameters in FDG-imaging and MR DWI is investigated.

Methods

In this retrospective, single-center study we analyzed patients diagnosed with oropharyngeal cancer between January 2018 and December 2020 at a tertiary center in Switzerland. HPV status was assessed via p16 immunohistochemistry and/or PCR. Standardized uptake value (SUV), total lesion glycolysis (TLG) and apparent diffusion coefficient (ADC) were measured in pretreatment imaging (FDG-PET/CT, FDG-PET/MR, DWI MR). Statistical analysis was performed using Mann-Whitney-U tests. All p values reported are two-sided, and p values < 0.05 were considered statistically significant.

Results

142 patients were included. 67% of tumors were HPV-positive. Mean SUV_max in FDG-PET was 15.0+/-5.9 for HPV-positive tumors and 18.6+/-9.7 for HPV-negative tumors (p = 0.15). Mean ADC was 1109 x 10⁶ mm²/s+/-326.8 for HPV-positive tumors and 1045.8 x 10⁶ mm²/s+/-467.0 for HPV-negative tumors (p = 0.76).

Conclusion

and Relevance: We found no correlation between oropharyngeal carcinoma HPV status and any of the analyzed imaging parameters.