Difference Between HPV-Positive and HPV-Negative Non-Oropharyngeal Head and Neck Cancer: Texture Analysis Features on CT

Objective: To identify the specific texture parameter that shows significant differences between human papillomavirus (HPV)-positive (HPV+) and HPV-negative (HPV-) non-oropharyngeal carcinoma (non-OPC) using texture analysis. Methods: Forty-six patients of non-OPC patients (oral cavity, larynx, and hypopharynx) with known HPV status, who underwent contrast-enhanced computed tomography for initial staging, were retrospectively reviewed. Segmentations of the primary lesion were manually performed, and an in-house developed texture analysis program extracted 42 texture features from each segmented volume. A t test was used to evaluate differences between HPV+ and HPV-non-OPCs (P < 0.05). Results: Sixteen texture parameters, including 5 histogram features (P <= 0.03), 3 gray-level co-occurrence matrix features (P <= 0.02), 1 gray-level run-length feature (P = 0.009), 2 gray-level gradient matrix features (P <= 0.02), and 5 Law features (P <= 0.04), showed significant differences. Conclusions: Texture analysis demonstrated significant differences between HPV+ and HPV- non-OPCs on computed tomography images, which may have a potential to prove morphologic feature differences among HPV-related tumors.