Polish radiologist Dr. Agnieszka Trojanowska will shed light on human papilloma virus (HPV)-induced squamous cell cancer of the head and neck, a common yet long neglected type of cancer. In an interview with ECR Today, she also explained the origins of her passion for head and neck imaging, and how radiologists will increasingly benefit from computer science.

Dr. Agnieszka Trojanowska, assistant professor in the department of radiology and nuclear medicine at Lublin University Hospital, is an internationally recognised specialist in head and neck imaging. Her special interest for oncology and her natural curiosity led her to agree to deliver the Josef Lissner Honorary Lecture on HPV-induced squamous cell cancer of the head and neck (HNSCC) at ECR 2018.

Agnieszka Trojanowska from Lublin, Poland, will speak on HPV-induced squamous cell cancer of the head and neck in her Honorary Lecture today.

“HNSCC behaves differently than more well-known forms of SCC, and it is becoming more and more prevalent. It affects young, well-educated people with high socioeconomic status, and is a quickly rising sexually transmitted entity with peculiar clinical and molecular characteristics. In particular the rise of HPV-induced cancer has been observed in the United States since the beginning of 21^st century,” she said.

It was important for her to talk about this long overlooked topic, for which much remains to be done. “It has been under-estimated for many years in many countries. Nowadays, we can speak about an HPV epidemic, leading to a significant rise of oropharyngeal cancer incidences worldwide. These cancers are quite unique and, in my opinion, knowledge of their physiology and treatment options is essential,” she said.

New research shows that, compared with environmental-related head and neck squamous cell carcinomas, patients with HPV-related malignancies display a better response to treatment and a lower risk of death and progression, Dr. Trojanowska pointed out. It is also noteworthy that, according to the 2017 TNM classification, HPV+ cancers are evaluated with a separate grading scale, she added.

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Watch this session on ECR Live: Thursday, 16:00–17:30, Room E2
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Malignant primary bone tumours like osteosarcoma and Ewing’s sarcoma are very serious diseases mainly affecting children and teenagers. General radiologists are not likely to see these patients every day at their practice, but when they do, they must know what they have to do to optimise patient care and improve outcomes. Experts will give instructions and share useful advice during the dedicated Multidisciplinary Session today at the ECR.

Conventional x-ray of a tumour in the knee
(Image provided by Prof. Koenraad Verstraete)

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Watch this session on ECR Live: Monday, March 11, 08:30–10:00, Room N/O
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Organ-sparing surgery and radiation treatment such as intensity-modulated radiotherapy (IMRT) – often combined with chemotherapy – have increased the need for advanced imaging in the head and neck during pre-treament and post-treatment stages. Precision is vital as any tumour that remains undetected outside the treatment field could adversely affect the patients’ prognosis and survival, according to Professor Vincent Vandecaveye, from the department of radiology at the University Hospitals Leuven in Belgium.

It is important to spot any tumour recurrence as early as possible, especially in the post-treatment phase, in order give the patient the best possible chance of salvage treatment. The most common imaging methods in the head and neck area remain CT, MRI and PET-CT; each comes with its own advantages and disadvantages.

Multiparametric MRI for early treatment prediction of chemoradiation in oropharyngeal cancer: Upper row is pre-treatment MRI of right base of tongue cancer (a=contrast enhanced T1 as anatomical correlate; b=native b1000 diffusion-weighted image; c= ADC-map; d=perfusion-map of IUAC). Middle row is 2 weeks during chemoradiation: same imaging sets, tumour volume will not help. No significant change in b1000, ADC nor perfusion-MRI indicate non-response and thus high risk of tumour relapse after end of treatment. Tumour relapse at PET-CT 8 months after end of treatment, proven by histology (k). (Provided by Professor Vincent Vandecaveye)

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