title: Do 18F-FDG PET/CT parameters in oropharyngeal and oral cavity squamous cell carcinomas indicate HPV status?
abstract: OBJECTIVE
  The aim of this study was to explore the relationship of PET/CT parameters with human papillomavirus (HPV) status of oropharyngeal (OP) and oral cavity (OC) squamous cell carcinomas (SCCs).
  
  
  METHODS
  We retrospectively reviewed 39 patients with OC and OP-SCC who underwent staging 18F-FDG PET/CT. PET/CT parameters were measured for the primary tumor and the hottest involved node, including SUV max, SUV mean, SUV peak, metabolic tumor volume, total lesion glycolysis, standardized added metabolic activity (SAM), and normalized SAM. Patient characteristics were compared between HPV positive (HPV+) and negative (HPV-) groups. Receiver operating characteristic analysis was used to dichotomize PET/CT parameters into high and low. Logistic regression models predicting HPV status were fit for each PET/CT parameter.
  
  
  RESULTS
  The HPV+ group was composed of 18 patients all with OP-SCC; the HPV- group consisted of 21 patients, 4 OP cancer patients and 17 OC cancer patients. The HPV+ group had a higher proportion of N2 stage (94% vs 43%; P < 0.001). Nodal PET/CT parameters were higher in the HPV+ group (P < 0.01); this difference was not present for the primary lesion. After adjusting for sex and age, the association of higher nodal SUV max (odds ratio [OR], 9.67), SUV mean (OR, 10.48), SUV peak (OR 9.67), metabolic tumor volume (OR, 14.52), total lesion glycolysis (OR, 11.84), and SAM, normalized SAM (OR, 16.21) with HPV+ status remained statistically significant (P < 0.05).
  
  
  CONCLUSIONS
  Nodal PET/CT parameters predict HPV status. High nodal FDG uptake should raise suspicion for positive HPV status in the evaluation of the primary lesion.
authors.affiliation: From the *Department of Radiology and Imaging Sciences, Emory University; †Veterans Affairs Medical Center; ‡Department of Pathology, Emory University; §Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute of Emory University; ∥Department of Radiation Oncology, Emory University; ¶Department of Hematology Oncology, Winship Cancer Institute of Emory University; **Georgia Cancer Scholar, Department of Otolaryngology, Emory University; and ††Department of Otolaryngology, Emory University, Atlanta, GA.
authors.forename: Ayse Tuba Karagulle
authors.initials: AT
authors.lastname: Kendi
authors.forename: Kelly
authors.initials: K
authors.lastname: Magliocca
authors.forename: Amanda
authors.initials: A
authors.lastname: Corey
authors.forename: Dana C
authors.initials: DC
authors.lastname: Nickleach
authors.forename: James
authors.initials: J
authors.lastname: Galt
authors.forename: Kristin
authors.initials: K
authors.lastname: Higgins
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Beitler
authors.forename: Mark W
authors.initials: MW
authors.lastname: El-Deiry
authors.forename: J Trad
authors.initials: JT
authors.lastname: Wadsworth
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Hudgins
authors.forename: Nabil F
authors.initials: NF
authors.lastname: Saba
authors.forename: David M
authors.initials: DM
authors.lastname: Schuster
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000821:virology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000000981:diagnostic imaging* / Q000821:virology; D064847:Multimodal Imaging; D009959:Oropharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000821:virology; D027383:Papillomaviridae / Q000302:isolation & purification*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18