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

Rathan M. Subramaniam, Krishna C. Alluri, Abdel K. Tahari, Nafi Aygun, Harry Quon

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) represents an emerging disease that differs from HPV-negative OPSCC in natural history and prognosis. Contrastenhanced 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 treatmentrelated toxicities. 18F-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.

Original languageEnglish (US)
Pages (from-to)431-438
Number of pages8
JournalJournal of Nuclear Medicine
Volume55
Issue number3
DOIs
StatePublished - Mar 1 2014

Keywords

  • General oncology
  • HPV
  • OPSCC
  • PET/CT

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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