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

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  < 0.001). The median progression free survival was 28 months, if the first follow‐up scan performed within 6–12 months post‐treatment completion was negative. Conclusion Follow‐up FDG PET / CT scans have an impact on the management plan and add value to clinical assessment in patients with HPV ‐positive OPSCC .