Multiparametric MRI Evaluation of Oropharyngeal Squamous Cell Carcinoma. A Mono-Institutional Study

Abstract

The aim of this paper is to define the pre-treatment radiological characteristics of oropharyngeal squamous cell carcinoma (OPSCC) using morphological and non-morphological magnetic resonance imaging (MRI), based on HPV status, in a single-institution cohort. In total, 100 patients affected by OPSCC were prospectively enrolled in the present study. All patients underwent 1.5T MR with standard sequences, including diffusion-weighted imaging with and intravoxel incoherent motion (IVIM-DWI) technique and a dynamic contrast-enhanced (DCE) MRI. For all patients, human papillomavirus (HPV) status was available. No statistically significant differences in the volume of primary tumors (PTs) and lymph nodes (LNs) were observed based on HPV status. When comparing the two patient groups, no significant differences were found for the PT radiologic characteristics (presence of well-defined borders, exophytic growth, ulceration, and necrosis) and LN morphology (solid/cystic/necrotic). Tumor subsite, smoking status, and alcohol intake significantly differed based on HPV status, as well as ADC and Dt values of both PTs and LNs. We detected no significant difference in DCE-MRI parameters by HPV status. Based on a multivariate logistic regression model, the combination of clinical factors, such as tumor subsite and alcohol habits, with the perfusion-free diffusion coefficient Dt of LNs, may help to accurately discriminate OPSCC by HPV status.

Relating pre-treatment non-Gaussian intravoxel incoherent motion diffusion-weighted imaging to human papillomavirus status and response in oropharyngeal carcinoma

“…We found that the ADC and all NG-IVIM parameters were related to HPV status. HPV-negative patients had a higher ADC and NG-IVIM parameter D than HPV-positive patients, which is in line with existing literature [4] , [9] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] . Since HPV-negative patients in general have a worse response to treatment than HPV-positive patients, that finding by itself would suggest that a high ADC is related to a poorer response, which has been reported also before in studies about pre-treatment DWI that did not correct for HPV status [1] , [32] , [33] .…”

MRI for Differentiation between HPV-Positive and HPV-Negative Oropharyngeal Squamous Cell Carcinoma: A Systematic Review

“…Twenty-one studies had a retrospective cohort study design [2,[19][20][21][22]25,26,28,29,31,32,35,[37][38][39]42,44,45,[47][48][49], and seven studies had a prospective cohort study design [23,27,40,41,43,46,50]. Of the twentyeight included papers, five papers focused on structural MRI sequences that were used in routine clinical examinations [19][20][21][22][23], nineteen focused on DWI sequences [2,25,[27][28][29]31,32,35,36,38,39,41,42,[44][45][46][47]...…”

“…Eleven studies used 1.5T MRI scanners [19,25,27,28,38,43,[45][46][47]49,50], nine studies used 3.0T MRI scanners [20,22,26,29,32,37,40,41,44], and eight studies used a combination of 1.5T and 3.0T MRI scanners [2,21,23,31,35,39,42,48]. Of the twenty-eight studies, nineteen investigated OPSCC exclusively [19][20][21][22][23]27,29,31,32,37,38,40,42,[44][45][46][47][48][49], three studies investigated oral cavity (OC)SCC as well as OPSCC [2,26,28], and ...…”

Imaging of human papilloma virus associated oropharyngeal squamous cell carcinoma and its impact on diagnosis, prognostication, and response assessment

“…Lower ADC and tissue diffusion coefficient (D t ) values have been observed in primary tumours and metastatic lymph nodes of patients with HPV+ OPC, with D t values achieving good levels of sensitivity (85.7–94.9%) and specificity (61.9–64.7%) when combined with risk factors, such as smoking and alcohol intake. 60,67 However, perfusion-related parameters, including the perfusion fraction (f) and perfusion-related diffusion coefficient (D*), have not been found to be discriminatory. 67 Due to the paucity of data and time consuming nature of the IVIM sequence, its use remains primarily in the research domain.…”

“… 70 However, a more recent study found no difference in DCE parameters between HPV+ and HPV- OPC. 60 Given the inconsistencies, further data are required before it can be relied upon to aid prediction of HPV status.…”