Solid Lymph Nodes as an Imaging Biomarker for Risk Stratification in Human Papillomavirus–Related Oropharyngeal Squamous Cell Carcinoma

Rath, Tanya J.; Narayanan, S.; Hughes, Marion A.; Ferris, Robert L.; Chiosea, Simion I.; Branstetter, Barton F.

doi:10.3174/ajnr.a5177

Cited by 19 publications

(10 citation statements)

References 27 publications

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“…Very few studies have investigated the associations between radiologic ENE on CT and survival outcomes in patients with HPV-related OPSCC. Rath et al (14) demonstrated that radiologic ENE was an independent worse predictor of disease-free survival in patients with HPV-related OPSCC (hazard ratio = 3.3, p = 0.001). In contrast, Liu et al (15) showed that radiologic ENE was not a significant prognosticator of PFS in patients with HPV-related OPSCC, although they did find a trend towards worse PFS with radiologic ENE ( p = 0.098), as in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…However, in a subset of patients with atypical features of HPV-related OPSCC, including radiologic ENE or matted lymph nodes, the cancer tends to show aggressive behavior, including local recurrence with distant metastases (111213). Recently, two studies that used CT to investigate the associations between radiologic ENE and survival outcomes in patients with HPV-related OPSCC yielded conflicting results: one showed that radiologic ENE had significant prognostic value (14), while the other found that it had no value (15). One previous study showed that contrast-enhanced magnetic resonance (MR) can be useful for lymph node characterization in head and neck squamous cell carcinoma (16).…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Value of Radiologic Extranodal Extension in Human Papillomavirus-Related Oropharyngeal Squamous Cell Carcinoma

et al. 2019

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Objective To determine whether radiologic extranodal extension (ENE) appearing on pretreatment CT and MRI could predict the prognosis in patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC). Materials and Methods The study population was obtained from a historical cohort diagnosed with HPV-related OPSCC. A total of 134 OPSCC patients who had a metastatic lymph node on pretreatment CT or MRI were included, and radiologic ENE was evaluated by two experienced head and neck radiologists. Kaplan-Meier and multivariate Cox regression analyses were performed to evaluate the impact of radiologic ENE on progression-free survival (PFS). The diagnostic performance of CT and MRI for the diagnosis of ENE was also evaluated in patients who underwent neck dissection. Results Seventy patients (52.2%) showed radiologic ENE-positive findings. Although patients showing radiologic ENE had a worse 3-year PFS (83.7% vs. 95.3%, p = 0.023), the association between radiologic ENE and PFS was not statistically significant on multivariate analysis ( p = 0.141; hazard ratio, 2.68; 95% confidence interval, 0.72–9.97). CT or MRI had a sensitivity of 62%, specificity of 77.8%, and accuracy of 71.9% for predicting pathologic ENE. Conclusion Radiologic ENE on CT or MRI did not predict poor PFS in patients with HPV-related OPSCC, although there was a trend towards worse PFS. Further studies are warranted to determine whether radiologic ENE is a useful imaging biomarker to risk-stratify patients with HPV-related OPSCC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Radiologic Extranodal Extension in Human Papillomavirus-Related Oropharyngeal Squamous Cell Carcinoma

et al. 2019

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“…Fine needle aspiration cytology (FNAC) with ultrasonography, computed tomography (CT), and MRI are the techniques generally used for the local staging of OPSCC, while positron emission tomography (PET)-CT is useful in locally advanced stages and for carcinomas of unknown primary origin [7][8][9][10][11]. Several studies [11][12][13][14] have reported differences in imaging features of OPSCC by HPV status. HPV-related lymph nodes (LNs) often tend to present with large cystic masses, with a clinically and radiologically smaller or even occult primary tumor (PT) [13].…”

Section: Introductionmentioning

confidence: 99%

Multiparametric MRI Evaluation of Oropharyngeal Squamous Cell Carcinoma. A Mono-Institutional Study

Piludu

Marzi

Gangemi

et al. 2021

JCM

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The aim of this paper is to define the pre-treatment radiological characteristics of oropharyngeal squamous cell carcinoma (OPSCC) using morphological and non-morphological magnetic resonance imaging (MRI), based on HPV status, in a single-institution cohort. In total, 100 patients affected by OPSCC were prospectively enrolled in the present study. All patients underwent 1.5T MR with standard sequences, including diffusion-weighted imaging with and intravoxel incoherent motion (IVIM-DWI) technique and a dynamic contrast-enhanced (DCE) MRI. For all patients, human papillomavirus (HPV) status was available. No statistically significant differences in the volume of primary tumors (PTs) and lymph nodes (LNs) were observed based on HPV status. When comparing the two patient groups, no significant differences were found for the PT radiologic characteristics (presence of well-defined borders, exophytic growth, ulceration, and necrosis) and LN morphology (solid/cystic/necrotic). Tumor subsite, smoking status, and alcohol intake significantly differed based on HPV status, as well as ADC and Dt values of both PTs and LNs. We detected no significant difference in DCE-MRI parameters by HPV status. Based on a multivariate logistic regression model, the combination of clinical factors, such as tumor subsite and alcohol habits, with the perfusion-free diffusion coefficient Dt of LNs, may help to accurately discriminate OPSCC by HPV status.

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“…Cystic lesions were defined as those that included more than 30% of the low-density area. Because previous studies used a cut-off value of 20% [3], we used a cut-off value of 30% in the present study to make the definition as cyst lesions more consistent. The design of this study was approved by our Institutional Review Board and Ethics Committee (approval number: 31-083 [9582]).…”

Section: Methodsmentioning

confidence: 99%

Radiological differences in computed tomography findings and texture analysis between cystic lymph node metastases of human papillomavirus-positive oropharyngeal cancer and second branchial cysts

et al. 2021

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Purpose:The study aimed to analyse radiological differences in computed tomography (CT) findings and texture analysis between cystic lymph node metastases (CNM) in human papillomavirus (HPV)-positive oropharyngeal cancer (OPC) and second branchial cleft cysts (2 nd BC). Material and methods:Patients with pathological evidence of CNM-HPV-OPC and 2 nd BC, who underwent contrastenhanced CT, were retrospectively evaluated. The evaluated characteristics include age, sex, and CT findings. CT findings included the maximum and minimum transverse diameters, maximum caudal diameter, thickness of the peripheral wall, presence of internal septation, presence of surrounding fat stranding, location, and 40 texture parameters.Results: A total of 13 patients had CNM-HPV-OPC (19 lesions), while 20 patients had 2 nd BC (20 lesions). Patients with 2 nd BC were significantly younger than those with CNM-HPV-OPC (p < 0.001). In terms of diameter, 2 nd BC lesions were significantly larger than the CNM-HPV-OPC lesions (p < 0.001). CNM-HPV OPC lesions had significantly thicker walls than 2 nd BC lesions (p < 0.001). CNM-HPV-OPC lesions had significantly higher association with internal septations than 2 nd BC lesions (p < 0.001). Second BC lesions were significantly less common at level III than CNM-HPV-OPC lesions (p = 0.047). Among the 40 texture parameters measured, 8 had significant differences (p ≤ 0.001).Conclusions: There were significant differences in CT findings and textural parameters between CNM-HPV-OPC and 2 nd BC lesions. These results may help in differentiating one from the other.

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Solid Lymph Nodes as an Imaging Biomarker for Risk Stratification in Human Papillomavirus–Related Oropharyngeal Squamous Cell Carcinoma

Cited by 19 publications

References 27 publications

Prognostic Value of Radiologic Extranodal Extension in Human Papillomavirus-Related Oropharyngeal Squamous Cell Carcinoma

Prognostic Value of Radiologic Extranodal Extension in Human Papillomavirus-Related Oropharyngeal Squamous Cell Carcinoma

Multiparametric MRI Evaluation of Oropharyngeal Squamous Cell Carcinoma. A Mono-Institutional Study

Radiological differences in computed tomography findings and texture analysis between cystic lymph node metastases of human papillomavirus-positive oropharyngeal cancer and second branchial cysts

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