Morphologic and topographic radiologic features of human papillomavirus-related and –unrelated oropharyngeal carcinoma
Michael W. Chan MD
Department of Medical Imaging, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorEugene Yu MD
Department of Medical Imaging, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada
These authors contributed equally to this study.
Search for more papers by this authorEric Bartlett MD
Department of Medical Imaging, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada
Search for more papers by this authorBrian O'Sullivan MD
Department of Radiation Oncology, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Department of Otolaryngology - Head and Neck Surgery, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorJie Su MSc
Department of Biostatistics, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorJohn Waldron MD
Department of Radiation Oncology, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Department of Otolaryngology - Head and Neck Surgery, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorJolie Ringash MD
Department of Radiation Oncology, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorScott V. Bratman MD
Department of Radiation Oncology, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorYingming Amy Chen MD
Department of Medical Imaging, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorJonathan Irish MD
Department of Otolaryngology - Head and Neck Surgery, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorJohn Kim MD
Department of Radiation Oncology, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorPatrick Gullane MD
Department of Otolaryngology - Head and Neck Surgery, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorRalph Gilbert MD
Department of Otolaryngology - Head and Neck Surgery, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorDouglas Chepeha MD
Department of Otolaryngology - Head and Neck Surgery, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorBayardo Perez-Ordonez MD
Department of Pathology, University Health Network, Toronto, Ontario, Canada
Search for more papers by this authorIlan Weinreb MD
Department of Pathology, University Health Network, Toronto, Ontario, Canada
Search for more papers by this authorAaron Hansen MD
Division of Medical Oncology, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorLi Tong BSc
Department of Radiation Oncology, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorWei Xu PhD
Department of Biostatistics, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorCorresponding Author
Shao Hui Huang MD, MSc, MRT(T)
Department of Radiation Oncology, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
These authors contributed equally to this study.
Correspondence Shao Hui Huang, Department of Radiation Oncology, and Eugene Yu, Department of Medical Imaging, The Princess Margaret Cancer Centre/University of Toronto, 610 University Ave, Toronto, Ontario, Canada, M5G 2M9. Email: [email protected], and [email protected]Search for more papers by this authorMichael W. Chan MD
Department of Medical Imaging, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorEugene Yu MD
Department of Medical Imaging, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada
These authors contributed equally to this study.
Search for more papers by this authorEric Bartlett MD
Department of Medical Imaging, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada
Search for more papers by this authorBrian O'Sullivan MD
Department of Radiation Oncology, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Department of Otolaryngology - Head and Neck Surgery, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorJie Su MSc
Department of Biostatistics, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorJohn Waldron MD
Department of Radiation Oncology, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Department of Otolaryngology - Head and Neck Surgery, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorJolie Ringash MD
Department of Radiation Oncology, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorScott V. Bratman MD
Department of Radiation Oncology, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorYingming Amy Chen MD
Department of Medical Imaging, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorJonathan Irish MD
Department of Otolaryngology - Head and Neck Surgery, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorJohn Kim MD
Department of Radiation Oncology, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorPatrick Gullane MD
Department of Otolaryngology - Head and Neck Surgery, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorRalph Gilbert MD
Department of Otolaryngology - Head and Neck Surgery, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorDouglas Chepeha MD
Department of Otolaryngology - Head and Neck Surgery, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorBayardo Perez-Ordonez MD
Department of Pathology, University Health Network, Toronto, Ontario, Canada
Search for more papers by this authorIlan Weinreb MD
Department of Pathology, University Health Network, Toronto, Ontario, Canada
Search for more papers by this authorAaron Hansen MD
Division of Medical Oncology, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorLi Tong BSc
Department of Radiation Oncology, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorWei Xu PhD
Department of Biostatistics, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorCorresponding Author
Shao Hui Huang MD, MSc, MRT(T)
Department of Radiation Oncology, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
These authors contributed equally to this study.
Correspondence Shao Hui Huang, Department of Radiation Oncology, and Eugene Yu, Department of Medical Imaging, The Princess Margaret Cancer Centre/University of Toronto, 610 University Ave, Toronto, Ontario, Canada, M5G 2M9. Email: [email protected], and [email protected]Search for more papers by this authorFunding information: The authors acknowledge the support of the Bartley-Smith/Wharton, the Gordon Tozer, the Wharton Head and Neck Translational, Dr Mariano Elia, and Petersen-Turofsky Funds, and “The Joe and Cara Finley Center for Head and Neck Cancer Research” at the Princess Margaret Cancer Foundation.
This work was presented in part at The Eastern Neuroradiological Society 28th Annual Meeting, Quebec, Canada, August 11-14, 2016, and received the Stephen A. Kieffer Award for the Best Mentored Paper.
Abstract
Background
The purpose of this study was to compare the clinicoradiologic characteristics of human papillomavirus (HPV)-related (HPV-positive) and HPV-unrelated (HPV-negative) oropharyngeal carcinoma (OPC).
Methods
Primary tumor and lymph node features of HPV-positive and HPV-negative OPCs from 2008 to 2013 were compared on pretreatment CT/MRI. Intrarater/interrater concordance was assessed. Multivariable analyses identified factors associated with HPV-positivity to be used in nomogram construction.
Results
Compared to HPV-negative (n = 194), HPV-positive (n = 488) tumors were more exophytic (73% vs 63%; p = .02) with well-defined border (58% vs 47%; p = .033) and smaller axial dimensions; lymph node involvement predominated (89% vs 69%; p < .001) with cystic appearance (45% vs 32%; p = .009) but similar topography. Intrarater/interrater concordance varied (fair to excellent). Nomograms combining clinical (age, sex, smoking pack-years, subsite, T/N classification) and/or radiologic (nonnecrotic tumor and cystic lymph node) features were used to weigh the likelihood of HPV-driven tumors (area under the curve [AUC] = 0.84).
Conclusion
HPV-positive OPC has different radiologic tumor (exophytic/well-defined border/smaller axial dimension) and lymph node (cystic) features but similar lymph node topography.
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