CT assessment of tumor heterogeneity and the potential for the prediction of human papillomavirus status in oropharyngeal squamous cell carcinoma

Radiol Med. 2019 Sep;124(9):804-811. doi: 10.1007/s11547-019-01028-6. Epub 2019 Mar 25.


The aim of this study is to find a correlation between tumoral heterogeneity of squamous cell carcinoma of the oropharynx and human papillomavirus (HPV) status and to determine whether analysis of texture features of primary lesion on contrast-enhanced CT (CECT) images can be useful in predicting the HPV positivity. Fifty patients with diagnosis of oropharyngeal carcinoma and pre-treatment CECT were included; tumoral heterogeneity of each lesion was evaluated by extracting quantitative texture parameters of first and higher orders. T test and logistic regression were conducted to evaluate the effects of different textural characteristics. There were 35 HPV+ and 15 HPV- lesions. Statistically significant (p < 0.05) differences were seen in multiple higher-order extracted parameters. The logistic regression model correctly classified lesions with an accuracy of 95.2%. CT texture analysis of primary oropharyngeal cancer may be used as a tool for predicting the HPV status.

Keywords: Computed tomography; Head and neck imaging; Human papillomavirus; Oropharyngeal cancer; Texture analysis.

MeSH terms

  • Aged
  • Correlation of Data
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Oropharyngeal Neoplasms / complications*
  • Oropharyngeal Neoplasms / diagnostic imaging*
  • Oropharyngeal Neoplasms / pathology
  • Papillomavirus Infections / complications*
  • Papillomavirus Infections / diagnostic imaging*
  • Predictive Value of Tests
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck / complications*
  • Squamous Cell Carcinoma of Head and Neck / diagnostic imaging*
  • Squamous Cell Carcinoma of Head and Neck / pathology
  • Tomography, X-Ray Computed*