PET/CT Diagnostic Accuracy for Synchronous Primary HPV-Positive Oropharyngeal Tumors: A Multi-Institutional Study.

Authors

Mei Xing G Zuo, Varsha Pudi, Srikar Ganapathiraju, Christopher P Kruglik, Kyra S Lee, Nihan Ercanli, Joseph A Paydarfar, Mirabelle B Sajisevi, Neil Gildener-Leapman, Lisa T Galati

Published in

Head & neck. Aug 30, 2026. Epub Aug 30, 2026.

Abstract

The incidence of human papillomavirus-associated (HPV) oropharyngeal squamous cell carcinoma (OPSCC) is rising, making accurate detection of synchronous primary tumors essential for staging and treatment planning.
This multi-institutional retrospective cohort study (2019-2026) included adult participants across three academic tertiary centers who underwent PET/CT and subsequent biopsy or surgical resection with histopathological confirmation of p16-positive disease.
Among 306 patients meeting inclusion criteria, PET/CT identified 15 suspicious for synchronous primary tumors; seven (mean age 58.90 ± 11.48 years) were pathologically confirmed. PET/CT demonstrated 77.78% sensitivity, 97.31% specificity, 46.67% positive predictive value (PPV), and 99.31% negative predictive value (NPV). False positives were attributed to physiologic bilateral uptake, reactive lymphoid tissue, or inflammation.
PET/CT demonstrates excellent NPV for excluding synchronous primary tumors in HPV-positive OPSCC and moderate PPV for identifying them. In settings of multifocal fluorodeoxyglucose uptake, pathologic confirmation is warranted prior to definitive management.

PMID:
42669587
Bibliographic data and abstract were imported from PubMed on 31 Aug 2026.

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