From: Imaging of human papilloma virus (HPV) related oropharynx tumour: what we know to date
Imaging technique | HPV+ | HPV- |
---|---|---|
Ultrasound | Â | Â |
Primary lesion | - | - |
Metastatic lymph nodes | Size > 8 mm (9 mm subdigastric IIa) Round shape | |
Hypoechoic cystic necrosis | Hyperechoic spots (coagulation necrosis)- rare Intranodal calcification | |
CT | Â | Â |
Primary lesion | Smaller Exophytic growth Well defined borders | Bigger Ill-defined borders Grows by invading submucosa and adjacent muscle tissue Necrosis Ulceration |
Metastatic lymph nodes | Cystic necrosis Well-defined borders Clustering | Extra-nodal extension Ill-defined borders Matting |
PET-CT | Â | Â |
 | Higher SUVmax | Lower SUVmax |
Conventional MRI | Â | |
Primary lesion | Same elements as CT but better overall definition | |
Metastatic lymph node | ||
DWI | Â | Â |
Primary lesion | Lower ADC and Dt; Leptokurtic Right skewed ADC histogram | Higher ADC and Dt; Symmetric Normally distributed ADC histogram |
Metastatic lymph node | ||
IVIM | No significant difference in D*, skewness, kurtosis | |
DKI | ||
DCE-MRI | Â | Â |
Primary lesion | Inconstant lower values of ktrans | - |
Metastatic lymph node |