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

Cohort studyHead & neck· Aug 2026

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

Mei Xing G Zuo, Varsha Pudi, Srikar Ganapathiraju … Lisa T Galati

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Oncologic ImagingCohort studyDiagnosis

PET/CT shows high negative predictive value for synchronous primary tumors in HPV-positive oropharyngeal squamous cell carcinoma.

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

Mei Xing G Zuo … Lisa T Galati

Head & neck · Aug 2026

Background

The incidence of human papillomavirus-associated (HPV) oropharyngeal squamous cell carcinoma (oropharyngeal squamous cell carcinoma) is rising, making accurate detection of synchronous primary tumors essential for staging and treatment planning.

Methods

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.

n = 306 patients

Results

If PET/CT is negative, synchronous tumors are very unlikely

97.31%

Sensitivity

46.67%

Specificity

More results

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.

False positives were attributed to physiologic bilateral uptake, reactive lymphoid tissue, or inflammation.

“

Conclusion · 1 of 2

PET/CT demonstrates excellent negative predictive value for excluding synchronous primary tumors in HPV-positive oropharyngeal squamous cell carcinoma and moderate positive predictive value for identifying them.

Conclusion · 2 of 2

In settings of multifocal fluorodeoxyglucose uptake, pathologic confirmation is warranted prior to definitive management.

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

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

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