Interaction of quantitative F-18-FDG-PET-CT imaging parameters and human papillomavirus status in oropharyngeal squamous cell carcinoma

Charlotte S. Schouten, Sara Hakim, R. Boellaard, Elisabeth Bloemena, Patricia A. Doornaert, Birgit I. Witte, Boudewijn J. M. Braakhuis, Ruud H. Brakenhoff, Rene Leemans, Otto S. Hoekstra, Remco de Bree

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Patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (SCC) have a better survival than with HPV-negative oropharyngeal SCC. An (18) F-fluorodeoxyglucose positron emission tomography-CT ((18) F-FDG-PET-CT) may also provide prognostic information. We evaluated glycolytic characteristics in HPV-negative and HPV-positive oropharyngeal SCC. METHODS: Forty-four patients underwent pretreatment (18) F-FDG-PET-CT. Standardized uptake values (SUVs) and metabolic active tumor volumes (MATVs) were determined for primary tumors. HPV status was determined with p16 immunostaining, followed by high-risk HPV DNA detection on the positive cases. RESULTS: Twenty-seven patients were HPV-positive (61.4%). Median MATV was 2.8 mL (range = 1.6-5.1 mL) for HPV-positive and 6.0 mL (range = 4.4-18.7 mL) for HPV-negative tumors (p <.001). SUV values are volume dependent (partial volume effect), therefore, MATV was included as covariate in multivariate analysis. In this multivariate analysis, the maximum SUV in HPV-positive tumors was 3.9 units lower than in HPV-negative tumors (p = .01). CONCLUSION: The (18) F-FDG-PET-CT parameters are lower in HPV-positive than in HPV-negative patients. Low pretreatment SUV values in HPV-positive oropharyngeal SCC may be at least partly explained by HPV-induced tumor changes
Original languageEnglish
Pages (from-to)529-535
Number of pages7
JournalHead and Neck
Issue number4
Publication statusPublished - Apr 2016


  • F-18-fluorodeoxyglucose positron emission tomography-CT (F-18-FDG PET-CT)
  • human papillomavirus
  • metabolic active tumor volume
  • oropharyngeal squamous cell carcinoma
  • standardized uptake value
  • tumor heterogeneity

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