Post‐treatment 18F‐fludeoxyglocuse‐positron emission tomography in human papillomavirus‐associated oropharyngeal cancer

Abstract

AbstractBackgroundHuman papillomavirus association has changed the landscape of treatment for oropharyngeal squamous cell carcinoma; it remains to be seen whether current post‐treatment surveillance schedules are effective.ObjectiveEvaluate whether post‐treatment surveillance of oropharyngeal cancer through FDG‐PET imaging is modified by human papillomavirus association.MethodsA prospective cohort analysis of retrospective data was conducted for patients undergoing treatment of oropharyngeal cancer between 2016 and 2018. This study was conducted at a single large tertiary referral center in Brisbane, Australia.ResultsTwo‐hundred and twenty‐four patients were recruited for the purposes of the study, 193 (86%) with HPV‐associated disease. In this cohort FDG‐PET had a sensitivity of 48.3%, specificity of 72.6%, positive predictive value of 23.7%, and negative predictive value of 88.8% in detecting disease recurrence.ConclusionsFDG‐PET in HPV‐associated oropharyngeal cancer has significantly lower positive predictive value when compared to non‐HPV‐associated oropharyngeal cancer. Caution should be used when interpreting positive post‐treatment FDG‐PET.