Department of Radiology, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.
Department of Neuroradiology, Kings College Hospital NHS Trust, London, United Kingdom.
Br J Radiol. 2022 Sep 1;95(1138):20220149. doi: 10.1259/bjr.20220149. Epub 2022 Jun 28.
The clinical behaviour and outcomes of patients with oropharyngeal cancer (OPC) may be dichotomised according to their association with human papilloma virus (HPV) infection. Patients with HPV-associated disease (HPV+OPC) have a distinct demographic profile, clinical phenotype and demonstrate considerably better responses to chemoradiotherapy. This has led to a reappraisal of staging and treatment strategies for HPV+OPC, which are underpinned by radiological data. Structural modalities, such as CT and MRI can provide accurate staging information. These can be combined with ultrasound-guided tissue sampling and functional techniques (such as diffusion-weighted MRI and F-fludeoxyglucose positron emission tomography-CT) to monitor response to treatment, derive prognostic information, and to identify individuals who might benefit from intensification or deintensification strategies. Furthermore, advanced MRI techniques, such as intravoxel incoherent motion and perfusion MRI as well as application of artificial intelligence and radiomic techniques, have shown promise in treatment response monitoring and prognostication. The following review will consider the contemporary role and knowledge on imaging in HPV+OPC.
根据是否与人类乳头瘤病毒(HPV)感染有关,口咽癌(OPC)患者的临床行为和结局可以分为两类。HPV 相关疾病(HPV+OPC)患者具有独特的人口统计学特征、临床表现,并对放化疗有明显更好的反应。这导致了对 HPV+OPC 的分期和治疗策略的重新评估,这些策略以影像学数据为基础。结构方式,如 CT 和 MRI,可以提供准确的分期信息。这些可以与超声引导的组织采样和功能技术(如扩散加权 MRI 和 F-氟脱氧葡萄糖正电子发射断层扫描-CT)相结合,以监测治疗反应、得出预后信息,并识别可能受益于强化或减量化策略的个体。此外,高级 MRI 技术,如体素内不相干运动和灌注 MRI 以及人工智能和放射组学技术的应用,在治疗反应监测和预后方面显示出了希望。以下综述将考虑 HPV+OPC 中影像学的当代作用和知识。