Advances in Imaging for HPV-Related Oropharyngeal Cancer: Applications to Radiation Oncology

Travis C Salzillo, Nicolette Taku, Kareem A Wahid, Brigid A McDonald, Jarey Wang, Lisanne V van Dijk, Jillian M Rigert, Abdallah S R Mohamed, Jihong Wang, Stephen Y Lai, Clifton D Fuller

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While there has been an overall decline of tobacco and alcohol-related head and neck cancer in recent decades, there has been an increased incidence of HPV-associated oropharyngeal cancer (OPC). Recent research studies and clinical trials have revealed that the cancer biology and clinical progression of HPV-positive OPC is unique relative to its HPV-negative counterparts. HPV-positive OPC is associated with higher rates of disease control following definitive treatment when compared to HPV-negative OPC. Thus, these conditions should be considered unique diseases with regards to treatment strategies and survival. In order to sufficiently characterize HPV-positive OPC and guide treatment strategies, there has been a considerable effort to diagnose, prognose, and track the treatment response of HPV-associated OPC through advanced imaging research. Furthermore, HPV-positive OPC patients are prime candidates for radiation de-escalation protocols, which will ideally reduce toxicities associated with radiation therapy and has prompted additional imaging research to detect radiation-induced changes in organs at risk. This manuscript reviews the various imaging modalities and current strategies for tackling these challenges as well as provides commentary on the potential successes and suggested improvements for the optimal treatment of these tumors.

Original languageEnglish
Pages (from-to)371-388
Number of pages18
JournalSeminars in radiation oncology
Issue number4
Publication statusPublished - Oct-2021
Externally publishedYes


  • Head and Neck Neoplasms
  • Humans
  • Oropharyngeal Neoplasms/diagnostic imaging
  • Papillomavirus Infections/complications
  • Radiation Oncology

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