Imaging of human papilloma virus associated oropharyngeal squamous cell carcinoma and its impact on diagnosis, prognostication, and response assessment

Touska, Philip; Connor, Steve

doi:10.1259/bjr.20220149

Cited by 8 publications

(3 citation statements)

References 158 publications

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“…When it comes to HPV-correlation, multiple studies have shown that HPV + cancers tend to present themselves with higher SUVmax values when compared to HPV- tumors [ 41 , 45 ]. As such PET-CT can be another instrument to help infer HPV status in oropharyngeal cancer.…”

Section: Diagnostic Role Of Pet-ctmentioning

confidence: 99%

Imaging of human papilloma virus (HPV) related oropharynx tumour: what we know to date

Bicci,

Calamandrei,

Mungai

et al. 2023

Infect Agents Cancer

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The tumours of head and neck district are around 3% of all malignancies and squamous cell carcinoma is the most frequent histotype, with rapid increase during the last two decades because of the increment of the infection due to human papilloma virus (HPV). Even if the gold standard for the diagnosis is histological examination, including the detection of viral DNA and transcription products, imaging plays a fundamental role in the detection and staging of HPV + tumours, in order to assess the primary tumour, to establish the extent of disease and for follow-up. The main diagnostic tools are Computed Tomography (CT), Positron Emission Tomography-Computed Tomography (PET-CT) and Magnetic Resonance Imaging (MRI), but also Ultrasound (US) and the use of innovative techniques such as Radiomics have an important role. Aim of our review is to illustrate the main imaging features of HPV + tumours of the oropharynx, in US, CT and MRI imaging. In particular, we will outline the main limitations and strengths of the various imaging techniques, the main uses in the diagnosis, staging and follow-up of disease and the fundamental differential diagnoses of this type of tumour. Finally, we will focus on the innovative technique of texture analysis, which is increasingly gaining importance as a diagnostic tool in aid of the radiologist.

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Section: Diagnostic Role Of Pet-ctmentioning

confidence: 99%

Imaging of human papilloma virus (HPV) related oropharynx tumour: what we know to date

Bicci,

Calamandrei,

Mungai

et al. 2023

Infect Agents Cancer

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“…Magnetic Resonance Imaging (MRI) is the reference imaging technique for the evaluation of SCC due to its better soft tissue visualization than Computed Tomography (CT) [ 8 , 9 ]. For this reason, MRI is also recommended for staging by the American Joint Committee on Cancer [ 2 , 10 – 12 ]. Chemoradiotherapy (RT-CHT) is one of the cornerstones for treatment of both early and locally advanced forms of NPC, although outcome is very heterogeneous [ 6 , 13 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging in naso-oropharyngeal carcinoma: role of texture analysis in the assessment of response to radiochemotherapy, a preliminary study

et al. 2023

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Objective Identifying MRI texture parameters able to distinguish inflammation, fibrosis, and residual cancer in patients with naso-oropharynx carcinoma after radiochemotherapy (RT-CHT). Material and methods In this single-centre, observational, retrospective study, texture analysis was performed on ADC maps and post-gadolinium T1 images of patients with histological diagnosis of naso-oropharyngeal carcinoma treated with RT-CHT. An initial cohort of 99 patients was selected; 57 of them were later excluded. The final cohort of 42 patients was divided into 3 groups (inflammation, fibrosis, and residual cancer) according to MRI, 18F-FDG-PET/CT performed 3–4 months after RT-CHT, and biopsy. Pre-RT-CHT lesions and the corresponding anatomic area post-RT-CHT were segmented with 3D slicer software from which 107 textural features were derived. T-Student and Wilcoxon signed-rank tests were performed, and features with p-value < 0.01 were considered statistically significant. Cut-off values—obtained by ROC curves—to discriminate post-RT-CHT non-tumoural changes from residual cancer were calculated for the parameters statistically associated to the diseased status at follow-up. Results Two features—Energy and Grey Level Non-Uniformity—were statistically significant on T1 images in the comparison between ‘positive’ (residual cancer) and ‘negative’ patients (inflammation and fibrosis). Energy was also found to be statistically significant in both patients with fibrosis and residual cancer. Grey Level Non-Uniformity was significant in the differentiation between residual cancer and inflammation. Five features were statistically significant on ADC maps in the differentiation between ‘positive’ and ‘negative’ patients. The reduction in values of such features between pre- and post-RT-CHT was correlated with a good response to therapy. Conclusions Texture analysis on post-gadolinium T1 images and ADC maps can differentiate residual cancer from fibrosis and inflammation in early follow-up of naso-oropharyngeal carcinoma treated with RT-CHT.

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“…While there are reports on diverging imaging features of both primary tumor site and affected lymph nodes depictable on computed tomography (CT) and magnetic resonance imaging (MRI), differentiation of HPV infection status by cross-sectional imaging on an individual basis is still considered challenging [8]. The radiomics research field leverages reproducible quantitative representations of gray value patterns to convert medical imaging data into minable high-dimensional feature space to facilitate machine-based analysis [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

A Radiomics-Based Machine Learning Perspective on the Parotid Gland as a Potential Surrogate Marker for HPV in Oropharyngeal Cancer

Prasse,

Glaas,

Meyer

et al. 2023

Cancers

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Background: In treatment of oropharyngeal squamous cell carcinoma (OPSCC), human papillomavirus status (HPV) plays a crucial role. The HPV-positive subtype tends to affect younger patients and is associated with a more favorable prognosis. HPV-associated lesions have been described in the parotid gland, which is included in routine imaging for OPSCC. This work aims to explore the ability of an ML system to classify HPV status based on imaging of the parotid gland, which is routinely depicted on staging imaging. Methods: Using a radiomics approach, we investigate the ability of five contemporary machine learning (ML) models to distinguish between HPV-positive and HPV-negative OPSCC based on non-contrast computed tomography (CT) data of tumor volume (TM), locoregional lymph node metastasis (LNM), and the parotid gland (Parotid). After exclusion of cases affected by streak artefacts, 53 patients (training set: 39; evaluation set: 14) were retrospectively evaluated. Classification performances were tested for significance against random optimistic results. Results: The best results are AUC 0.71 by XGBoost (XGB) for TM, AUC 0.82 by multi-layer perceptron (MLP) for LNM, AUC 0.76 by random forest (RF) for Parotid, and AUC 0.86 by XGB for a combination of all three regions of interest (ROIs). Conclusions: The results suggest involvement of the parotid gland in HPV infections of the oropharyngeal region. While the role of HPV in parotid lesions is under active discussion, the migration of the virus from the oral cavity to the parotid gland seems plausible. The imaging of the parotid gland offers the benefit of fewer streak artifacts due to teeth and dental implants and the potential to screen for HPV in cases of an absent or unlocatable tumor. Future investigation can be directed to validation of the results in independent datasets and to the potential of improvement of current classification models by addition of information based on the parotid gland.

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Imaging of human papilloma virus associated oropharyngeal squamous cell carcinoma and its impact on diagnosis, prognostication, and response assessment

Cited by 8 publications

References 158 publications

Imaging of human papilloma virus (HPV) related oropharynx tumour: what we know to date

Imaging of human papilloma virus (HPV) related oropharynx tumour: what we know to date

Magnetic resonance imaging in naso-oropharyngeal carcinoma: role of texture analysis in the assessment of response to radiochemotherapy, a preliminary study

A Radiomics-Based Machine Learning Perspective on the Parotid Gland as a Potential Surrogate Marker for HPV in Oropharyngeal Cancer

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