title: FDG PET/CT imaging of oropharyngeal squamous cell carcinoma: characteristics of human papillomavirus-positive and -negative tumors.
abstract: OBJECTIVE
  The objective of this study was to assess differences in morphological and glycolytic characteristics of primary tumors and locoregional nodal disease between human papillomavirus (HPV)-positive and HPV-negative oropharyngeal head and neck squamous cell carcinoma.
  
  
  METHODS
  This was a retrospective analysis of 123 baseline FDG PET/CT scans from patients (aged 57.0 ± 10.6 years) with newly diagnosed oropharyngeal SCC between January 2003 and June 2012. There were 98 HPV-positive and 25 HPV-negative patients. SUVmax, SUVpeak, and SUVmean based on lean body mass, as well as RECIST (Response Evaluation Criteria In Solid Tumors) dimensions, metabolic tumor volume (gradient and threshold-segmentation methods) and total lesion glycolysis, were determined for primary and locoregional nodal disease.
  
  
  RESULTS
  Human papillomavirus-negative primary tumors were significantly larger as measured by RECIST longest diameter (P = 0.002) and slightly more heterogeneous as measured by the heterogeneity index (P = 0.07), higher SUVmax (P < 0.01), SUVpeak (P = 0.01), SUVmean (P = 0.01), metabolic tumor volume (P = 0.002), and total lesion glycolysis (P = 0.001), for both segmentation methods. Index parameters of HPV-positive nodal disease tend to be larger, but some with no statistical significance (P > 0.05). There was no significant difference in the metabolic parameters of primary tumor or nodal metastases for HPV-positive patients with and without smoking history.
  
  
  CONCLUSIONS
  Index morphologic and glycolytic parameters as measured in FDG PET/CT are significantly larger in HPV-negative as compared with HPV-positive primary oropharyngeal carcinoma. In contrast, the same parameters trended to be larger in HPV-positive regional nodal disease.
authors.affiliation: From the *Russell H. Morgan Department of Radiology and Radiological Sciences and Departments of †Radiation Oncology; and ‡Otolaryngology and Head and Neck Surgery, Johns Hopkins University, Baltimore, MD.
authors.forename: Abdel K
authors.initials: AK
authors.lastname: Tahari
authors.forename: Krishna C
authors.initials: KC
authors.lastname: Alluri
authors.forename: Harry
authors.initials: H
authors.lastname: Quon
authors.forename: Wayne
authors.initials: W
authors.lastname: Koch
authors.forename: Richard L
authors.initials: RL
authors.lastname: Wahl
authors.forename: Rathan M
authors.initials: RM
authors.lastname: Subramaniam
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000000981:diagnostic imaging* / Q000821:virology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009959:Oropharyngeal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000821:virology*; D027383:Papillomaviridae / Q000502:physiology; D030361:Papillomavirus Infections / Q000150:complications*; D049268:Positron-Emission Tomography; D012907:Smoking / Q000009:adverse effects; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18