¹⁸F-FDG PET/CT Parameters Enhance MRI Radiomics for Predicting Human Papilloma Virus Status in Oropharyngeal Squamous Cell Carcinoma

Purpose: Predicting human papillomavirus (HPV) status is critical in oropharyngeal squamous cell carcinoma (OPSCC) ra-diomics. In this study, we developed a model for HPV status prediction using magnetic resonance imaging (MRI) radiomics and 1₈ F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/computed tomography (CT) parameters in patients with OPSCC. Materials and Methods: Patients with OPSCC who underwent¹⁸F-FDG PET/CT and contrast-enhanced MRI before treatment between January 2012 and February 2020 were enrolled. Training and test sets (3:2) were randomly selected.¹⁸F-FDG PET/CT parameters and MRI radiomics feature were extracted. We developed three light-gradient boosting machine prediction models using the training set: Model 1, MRI radiomics features; Model 2,¹⁸F-FDG PET/CT parameters; and Model 3, combination of MRI radiomics features and¹⁸F-FDG PET/CT parameters. Area under the receiver operating characteristic curve (AUROC) values were used to analyze the performance of the models in predicting HPV status in the test set. Results: A total of 126 patients (118 male and 8 female; mean age: 60 years) were included. Of these, 103 patients (81.7%) were HPV-positive, and 23 patients (18.3%) were HPV-negative. AUROC values in the test set were 0.762 [95% confidence interval (CI), 0.564–0.959], 0.638 (95% CI, 0.404–0.871), and 0.823 (95% CI, 0.668–0.978) for Models 1, 2, and 3, respectively. The net reclassifica-tion improvement of Model 3, compared with that of Model 1, in the test set was 0.119. Conclusion: When combined with an MRI radiomics model,¹⁸F-FDG PET/CT exhibits incremental value in predicting HPV status in patients with OPSCC.