Overview
Extranodal extension (ENE) is a significant prognostic factor in human papillomavirus-positive oropharyngeal squamous cell carcinoma (HPV+ OPSCC) 1. Accurate pretreatment determination of ENE is crucial for guiding treatment decisions 1.Diagnosis
No gold-standard imaging modality exists for radiological assessment of ENE in HPV+ OPSCC 1.
CT has an overall sensitivity of 77% and specificity of 60% for detecting ENE 1.
PET/CT has a sensitivity of 37.5% and specificity of 97% for detecting ENE 1.
Combined CT and MRI have a sensitivity of 62% and specificity of 78% for detecting ENE 1.
Further diagnostic studies involving CT, PET/CT, and MRI are required 1.Management
Treatment decisions concerning ENE are complex due to subjective imaging assessments 1.Key Recommendations
Pretreatment determination of extranodal extension (ENE) has significant clinical implications in HPV+ OPSCC 1. (Evidence: Moderate)
CT has a sensitivity of 77% and specificity of 60% for detecting ENE in HPV+ OPSCC 1. (Evidence: Moderate)
PET/CT has a sensitivity of 37.5% and specificity of 97% for detecting ENE in HPV+ OPSCC 1. (Evidence: Moderate)References
1 Morey T, Hodge JC, Stern C, Krishnan S, Foreman A. Correlation between radiologic and pathologic extranodal extension in HPV-associated oropharyngeal cancer: Systematic review. Head & neck 2022. link