Dual-layer detector spectral CT for predicting p16 status in head and neck squamous cell carcinoma

BackgroundHPV-positive head and neck squamous cell carcinoma (HNSCC) differs from HPV-negative HNSCC in clinical features, biological behavior, pathological manifestations, cytogenetics and tend to have better outcome. Immunohistochemical (IHC) p16 staining is highly sensitive for HPV status exam, but has a certain probability of false positives, and the accurate result of p16 expression could be challenging due to the limitation of the biopsy location and quantity. As a non-invasive approach, dual-layer detector spectral CT (DLSCT) provides multi-parameter quantitative analysis, which could help better reflect the changes of tumor characteristics. Hence, this study aimed to evaluate the spectral-derived differences between the p16( +) and p16(-) group of HNSCC so as to explore the application in preoperative diagnosis in differentiating the p16 expression status of HNSCC.Materials and methodsThe spectral data of 35 patients with biopsy confirmed HNSCC were retrospectively analyzed and compared between p16( +) (n = 11) and p16(-) (n = 25) group. All statistical analyses were performed on SPSS v26.0.ResultsEffective atomic number (Zeff), slope value of virtual monoenergetic image (VMI), and normalized iodine density (NID) of p16( +) group were all significantly lower than p16(-) group (8.36 (8.24, 8.42) vs. 8.57 (8.38, 8.85), 2.45 (2.22, 2.64) vs. 3.06 (2.50, 3.82), 0.43 & PLUSMN; 0.09 vs. 0.55 & PLUSMN; 0.14, respectively) (p < 0.05). Besides, NID showed a good ability to discriminate p16(-) HNSCC from p16( +) HNSCC (AUC = 0.788) with a threshold value of 0.495.ConclusionDLSCT could be helpful for the differentiation of p16 expression in HNSCC.