Pre-treatment PET/MRI based FDG and DWI imaging parameters for predicting HPV status and tumor response to chemoradiotherapy in primary oropharyngeal squamous cell carcinoma (OPSCC)
Omar Freihat, Zoltán Tóth, Tamás Pintér, András Kedves, Dávid Sipos, Zsolt Cselik, Norbert Lippai, Imre Repa, Árpád Kovács, Omar Freihat, Zoltán Tóth, Tamás Pintér, András Kedves, Dávid Sipos, Zsolt Cselik, Norbert Lippai, Imre Repa, Árpád Kovács
Abstract
Objectives: To determine the feasibility of pre-treatment primary tumor FDG-PET and DWI-MR imaging parameters in predicting HPV status and the second aim was to assess the feasibility of those imaging parameters to predict response to therapy.
Material and methods: We retrospectively analyzed primary tumors in 33 patients with proven OPSCC. PET/MRI was performed before and 6 months after chemo-radiotherapy for assessing treatment response. PET Standardized uptake value (SUVmax), total lesion glycolysis (TLG), metabolic tumor volume (MTV), and apparent diffusion coefficient (ADC) from pre-treatment measurements were assessed and compared to the clinicopathological characteristics (T stages, N stages, tumor grades, HPV and post-treatment follow up). HPV was correlated to the clinicopathological characteristics.
Results: ADCmean was significantly lower in patients with HPV+ve than HPV-ev, (P = 0.001), cut off value of (800 ± 0.44*10-3mm2/s) with 76.9% sensitivity, and 72.2% specificity is able to differentiate between the two groups. No significant differences were found between FDG parameters (SUVmax, TLG, and MTV), and HPV status, (P = 0.873, P = 0.958, and P = 0.817), respectively. Comparison between CR and NCR groups; ADCmean, TLG, and MTV were predictive parameters of treatment response, (P = 0.017, P = 0.013, and P = 0.014), respectively. HPV+ve group shows a higher probability of lymph nodes involvement, (P = 0.006) CONCLUSION: Our study found that pretreatment ADC of the primary tumor can predict HPV status and treatment response. On the other hand, metabolic PET parameters (TLG, and MTV) were able to predict primary tumor response to therapy.
Trial registration: ClinicalTrials.gov NCT04360993.
Keywords: Diffusion-Weighted Imaging; HPV; MTV; OPSCC; PET/MRI; Primary tumor; SUVmax; TLG; Tumor response.
Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Source: PubMed