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

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

Fingerprint

Papillomaviridae
Oropharyngeal Neoplasms
Squamous Cell Neoplasms
Squamous Cell Carcinoma
Neoplasm Metastasis
Fluorodeoxyglucose F18
Physiologic Monitoring
Natural History
Neck

Keywords

  • General oncology
  • HPV
  • OPSCC
  • PET/CT

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

PET/CT imaging and human papilloma virus-positive oropharyngeal squamous cell cancer : Evolving clinical imaging paradigm. / Subramaniam, Rathan M.; Alluri, Krishna C.; Tahari, Abdel K.; Aygun, Nafi; Quon, Harry.

In: Journal of Nuclear Medicine, Vol. 55, No. 3, 01.03.2014, p. 431-438.

Research output: Contribution to journalArticle

@article{ed838a95fc5146fda8121dbb4cb017cd,
title = "PET/CT imaging and human papilloma virus-positive oropharyngeal squamous cell cancer: Evolving clinical imaging paradigm",
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.",
keywords = "General oncology, HPV, OPSCC, PET/CT",
author = "Subramaniam, {Rathan M.} and Alluri, {Krishna C.} and Tahari, {Abdel K.} and Nafi Aygun and Harry Quon",
year = "2014",
month = "3",
day = "1",
doi = "10.2967/jnumed.113.125542",
language = "English (US)",
volume = "55",
pages = "431--438",
journal = "Journal of Nuclear Medicine",
issn = "0161-5505",
publisher = "Society of Nuclear Medicine Inc.",
number = "3",

}

TY - JOUR

T1 - PET/CT imaging and human papilloma virus-positive oropharyngeal squamous cell cancer

T2 - Evolving clinical imaging paradigm

AU - Subramaniam, Rathan M.

AU - Alluri, Krishna C.

AU - Tahari, Abdel K.

AU - Aygun, Nafi

AU - Quon, Harry

PY - 2014/3/1

Y1 - 2014/3/1

N2 - 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.

AB - 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.

KW - General oncology

KW - HPV

KW - OPSCC

KW - PET/CT

UR - http://www.scopus.com/inward/record.url?scp=84899485847&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84899485847&partnerID=8YFLogxK

U2 - 10.2967/jnumed.113.125542

DO - 10.2967/jnumed.113.125542

M3 - Article

VL - 55

SP - 431

EP - 438

JO - Journal of Nuclear Medicine

JF - Journal of Nuclear Medicine

SN - 0161-5505

IS - 3

ER -