PDF(Pubmed)
Abstract：
Human papillomavirus (HPV) is an important risk factor for oropharyngeal squamous cell carcinoma (OPSCC). HPV-positive (HPV+) cases are associated with a different pathophysiology, microstructure, and prognosis compared to HPV-negative (HPV-) cases. This review aimed to investigate the potential of magnetic resonance imaging (MRI) to discriminate between HPV+ and HPV- tumours and predict HPV status in OPSCC patients. A systematic literature search was performed on 15 December 2022 on EMBASE, MEDLINE ALL, Web of Science, and Cochrane according to PRISMA guidelines. Twenty-eight studies (n = 2634 patients) were included. Five, nineteen, and seven studies investigated structural MRI (e.g., T1, T2-weighted), diffusion-weighted MRI, and other sequences, respectively. Three out of four studies found that HPV+ tumours were significantly smaller in size, and their lymph node metastases were more cystic in structure than HPV- ones. Eleven out of thirteen studies found that the mean apparent diffusion coefficient was significantly higher in HPV- than HPV+ primary tumours. Other sequences need further investigation. Fourteen studies used MRI to predict HPV status using clinical, radiological, and radiomics features. The reported areas under the curve (AUC) values ranged between 0.697 and 0.944. MRI can potentially be used to find differences between HPV+ and HPV- OPSCC patients and predict HPV status with reasonable accuracy. Larger studies with external model validation using independent datasets are needed before clinical implementation.
摘要：
人乳头瘤病毒(HPV)是口咽鳞癌(OPSCC)的重要风险因子。HPV阳性（HPV+）病例与不同的病理生理学相关，微观结构，和与HPV阴性（HPV-）病例相比的预后。这篇综述旨在研究磁共振成像（MRI）在OPSCC患者中区分HPV和HPV肿瘤并预测HPV状态的潜力。2022年12月15日在EMBASE上进行了系统的文献检索，MEDLINE所有，WebofScience,和Cochrane根据PRISMA指南。包括28项研究（n=2634例患者）。五、十九,和七项研究调查了结构MRI(例如，T1，T2加权)，弥散加权磁共振成像,和其他序列，分别。四分之三的研究发现HPV+肿瘤的大小明显较小，和他们的淋巴结转移更多的囊性结构比HPV。13项研究中有11项发现HPV-原发性肿瘤的平均表观扩散系数明显高于HPV+原发性肿瘤。其他序列需要进一步调查。14项研究使用MRI预测HPV状态，使用临床，放射学,和影像组学特征。报告的曲线下面积(AUC)值在0.697和0.944之间。MRI可潜在地用于发现HPV+和HPV-OPSCC患者之间的差异并以合理的准确性预测HPV状态。在临床实施之前，需要使用独立数据集进行外部模型验证的大型研究。
