Human papillomavirus (HPV) is an important risk factor for oropharyngeal squamous cell carcinoma (OPSCC). HPV-positive (HPV+) cases are associated with a different pathophysiology, microstructure, and prognosis compared to HPV-negative (HPV−) cases. This review aimed to investigate the potential of magnetic resonance imaging (MRI) to discriminate between HPV+ and HPV− tumours and predict HPV status in OPSCC patients. A systematic literature search was performed on 15 December 2022 on EMBASE, MEDLINE ALL, Web of Science, and Cochrane according to PRISMA guidelines. Twenty-eight studies (n= 2634 patients) were included. Five, nineteen, and seven studies investigated structural MRI (e.g., T1, T2-weighted), diffusion-weighted MRI, and other sequences, respectively. Three out of four studies found that HPV+ tumours were significantly smaller in size, and their lymph node metastases were more cystic in structure than HPV− ones. Eleven out of thirteen studies found that the mean apparent diffusion coefficient was significantly higher in HPV− than HPV+ primary tumours. Other sequences need further investigation. Fourteen studies used MRI to predict HPV status using clinical, radiological, and radiomics features. The reported areas under the curve (AUC) values ranged between 0.697 and 0.944. MRI can potentially be used to find differences between HPV+ and HPV− OPSCC patients and predict HPV status with reasonable accuracy. Larger studies with external model validation using independent datasets are needed before clinical implementation.
人乳头瘤病毒（HPV）是口咽鳞状细胞癌（OPSCC）的重要危险因素。与HPV阴性（HPV−）病例相比，HPV阳性（HPV+）病例在病理生理学、微观结构和预后方面存在差异。本综述旨在探讨磁共振成像（MRI）在区分HPV+与HPV−肿瘤以及预测OPSCC患者HPV状态方面的潜力。根据PRISMA指南，于2022年12月15日对EMBASE、MEDLINE ALL、Web of Science和Cochrane数据库进行了系统性文献检索。共纳入28项研究（涉及2634名患者）。其中5项研究关注结构MRI（如T1、T2加权），19项研究关注扩散加权MRI，7项研究关注其他序列。四项研究中有三项发现，HPV+肿瘤体积显著小于HPV−肿瘤，且其淋巴结转移灶囊性结构更明显。十三项研究中有十一项显示，HPV−原发肿瘤的平均表观扩散系数显著高于HPV+肿瘤。其他序列需进一步研究。十四项研究利用临床、影像学及影像组学特征，通过MRI预测HPV状态，报告的曲线下面积（AUC）值介于0.697至0.944之间。MRI有望用于发现HPV+与HPV− OPSCC患者的差异，并以合理准确度预测HPV状态。在临床推广应用前，需开展更大规模研究，并利用独立数据集进行外部模型验证。
肿瘤(癌症)患者之家