Posttreatment FDG-PET/CT Hopkins criteria predict locoregional recurrence after definitive radiotherapy for oropharyngeal squamous cell carcinoma

Head Neck. 2022 Nov;44(11):2491-2504. doi: 10.1002/hed.27160. Epub 2022 Aug 3.

Abstract

Background: Metabolic response assessment for oropharyngeal squamous cell carcinoma (OPSCC) aids in identifying locoregional persistence/recurrence (LRR). The Hopkins Criteria are a standardized qualitative response assessment system using posttreatment FDG-PET/CT.

Methods: We conducted a retrospective cohort study of patients with node-positive OPSCC treated with definitive (chemo)radiotherapy. We assessed Hopkins Criteria performance for LRR, then developed and validated a competing-risks model.

Results: Between 2004 and 2018, 259 patients were included with median follow-up of 43 months. The Hopkins Criteria sensitivity, specificity, negative predictive value, and accuracy were 68%, 88%, 95%, and 85%. The 36-month cumulative incidence of LRR was greater with positive scores (45% vs. 5%, HR 12.60, p < 0.001). PET/CTs performed ≤10 weeks after radiotherapy were associated with a four-fold increase in pathologically negative biopsies/surgeries (36% vs. 9%, p = 0.03). The AUC for LRR was 0.89 using a model integrating the Hopkins score.

Conclusions: The Hopkins Criteria predict LRR with high accuracy for OPSCC response assessment.

Keywords: Hopkins criteria; PET/CT; locoregional recurrence; oropharynx cancer; response assessment.

MeSH terms

  • Fluorodeoxyglucose F18
  • Head and Neck Neoplasms*
  • Humans
  • Neoplasm Recurrence, Local / pathology
  • Oropharyngeal Neoplasms* / diagnostic imaging
  • Oropharyngeal Neoplasms* / pathology
  • Oropharyngeal Neoplasms* / radiotherapy
  • Positron Emission Tomography Computed Tomography
  • Radiopharmaceuticals
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18