The value of follow‐up FDG‐PET/CT in the management and prognosis of patients with HPV‐positive oropharyngeal squamous cell carcinoma

Introduction To establish the accuracy of follow‐up fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT and the impact of FDG PET/CT result on management decisions and patient outcome prediction (overall and progression free survival) in human papilloma virus (HPV)‐positive oropharyngeal squamous cell carcinoma (SCC). Patients and Methods We included 96 HPV‐positive oropharyngeal SCC (OPSCC) patients with 254 follow‐up PET/CT scans in the study. The PET/CT result accuracy was established with histopathology or 6‐month clinical follow‐up as reference standard. The impact on change in management was established for each follow‐up PET/CT scan. Overall survival was evaluated using Kaplan–Meier plots with a Log‐rank test. Results The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the follow‐up FDG‐PET/CT were 97.0%, 92.5%, 67.0%, 99.5% and 93.1%, respectively. Follow‐up PET/CT results were helpful in excluding tumour in 22% (9/41) of scans performed with prior clinical suspicion of disease and identified potential disease in 9.9% (21/213) scans performed without prior clinical suspicion. There was a change in management after 12.6% (32/254) scans. In 84.3% (214/254) scans, the patients were either observed or the same treatment was continued. The overall survival differed significantly between patients with a negative versus positive follow‐up scan (log rank P