title: Using Texture Analysis to Determine Human Papillomavirus Status of Oropharyngeal Squamous Cell Carcinomas on CT.
abstract: OBJECTIVE
  Human papillomavirus-associated oropharyngeal squamous cell carcinoma is increasing in prevalence and typically occurs in younger patients than human papillomavirus-negative squamous cell carcinoma. While imaging features of human papillomavirus-positive versus human papillomavirus-negative squamous cell carcinoma nodal metastases have been described, characteristics distinguishing human papillomavirus-positive from human papillomavirus-negative primary squamous cell carcinomas have not been well established. The purpose of this project was to evaluate the use of texture features to distinguish human papillomavirus-positive and human papillomavirus-negative primary oropharyngeal squamous cell carcinoma.
  
  
  METHODS
  Following institutional review board approval, 40 patients with primary oropharyngeal squamous cell carcinoma and known human papillomavirus status who underwent contrast-enhanced CT between December 2009 and October 2013 were included in this study. Segmentation of the primary lesion was manually performed with a semiautomated graphical-user interface. Following segmentation, an in-house-developed texture analysis program extracted 42 texture features from each segmented volume. A t test was used to evaluate differences in texture parameters between human papillomavirus-positive and human papillomavirus-negative squamous cell carcinomas.
  
  
  RESULTS
  Of the 40 included patients, 29 had human papillomavirus-positive oropharyngeal squamous cell carcinoma and 11 had human papillomavirus-negative oropharyngeal squamous cell carcinoma. Significant differences were seen in the histogram parameters median (P = .006) and entropy (P = .016) and squamous cell carcinoma entropy (P = .043).
  
  
  CONCLUSIONS
  There are statistically significant differences in some texture features between human papillomavirus-positive and human papillomavirus-negative oropharyngeal tumors. Texture analysis may be considered an adjunct to the evaluation of human papillomavirus status and characterization of squamous cell carcinoma.
authors.affiliation: From the Departments of Radiology (K.B., A.F., B.L., Y.K., O.S.).
authors.forename: K
authors.initials: K
authors.lastname: Buch
authors.affiliation: From the Departments of Radiology (K.B., A.F., B.L., Y.K., O.S.).
authors.forename: A
authors.initials: A
authors.lastname: Fujita
authors.affiliation: From the Departments of Radiology (K.B., A.F., B.L., Y.K., O.S.).
authors.forename: B
authors.initials: B
authors.lastname: Li
authors.affiliation: From the Departments of Radiology (K.B., A.F., B.L., Y.K., O.S.).
authors.forename: Y
authors.initials: Y
authors.lastname: Kawashima
authors.affiliation: Radiation Oncology (M.M.Q., O.S.).
authors.forename: M M
authors.initials: MM
authors.lastname: Qureshi
authors.affiliation: From the Departments of Radiology (K.B., A.F., B.L., Y.K., O.S.) Radiation Oncology (M.M.Q., O.S.) Otolaryngology-Head and Neck Surgery (O.S.), Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts. osamu.sakai@bmc.org.
authors.forename: O
authors.initials: O
authors.lastname: Sakai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000379:methods*
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