Imaging of human papilloma virus (HPV) related oropharynx tumour: what we know to date

Abstract

The tumours of head and neck district are around 3% of all malignancies and squamous cell carcinoma is the most frequent histotype, with rapid increase during the last two decades because of the increment of the infection due to human papilloma virus (HPV). Even if the gold standard for the diagnosis is histological examination, including the detection of viral DNA and transcription products, imaging plays a fundamental role in the detection and staging of HPV + tumours, in order to assess the primary tumour, to establish the extent of disease and for follow-up. The main diagnostic tools are Computed Tomography (CT), Positron Emission Tomography-Computed Tomography (PET-CT) and Magnetic Resonance Imaging (MRI), but also Ultrasound (US) and the use of innovative techniques such as Radiomics have an important role. Aim of our review is to illustrate the main imaging features of HPV + tumours of the oropharynx, in US, CT and MRI imaging. In particular, we will outline the main limitations and strengths of the various imaging techniques, the main uses in the diagnosis, staging and follow-up of disease and the fundamental differential diagnoses of this type of tumour. Finally, we will focus on the innovative technique of texture analysis, which is increasingly gaining importance as a diagnostic tool in aid of the radiologist.

Demographic and imaging features of oral squamous cell cancer in Serbia: a retrospective cross-sectional study

“…HPV-positive and negative OSCCs also exhibit different imaging features. On computed tomography (CT) or magnetic resonance (MR) imaging, HPV-positive cancer presents as a well-defined exophytic lesion with vivid enhancement and cystic lymph node metastasis [ 19 – 21 ]. By contrast, HPV-negative OSCCs are often larger and ill-defined, with a propensity for adjacent muscle invasion and extra-nodal extension [ 19 – 21 ].…”