Proton and Phosphorous MR Spectroscopy in Squamous Cell Carcinomas of the Head and Neck

Chawla, Sanjeev; Kim, Sungheon; Loevner, Laurie A.; Quon, Harry; Wang, Sumei; Mutale, Faith; Weinstein, Gregory; Delikatny, Edward J.; Poptani, Harish

doi:10.1016/j.acra.2009.06.001

« Previous Next »Academic Radiology
Volume 16, Issue 11 , Pages 1366-1372, November 2009

Proton and Phosphorous MR Spectroscopy in Squamous Cell Carcinomas of the Head and Neck

Sanjeev Chawla, PhD
- Department of Radiology, University of Pennsylvania, B6 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104
Sungheon Kim, PhD
- Department of Radiology, University of Pennsylvania, B6 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104
Laurie A. Loevner, MD
- Department of Radiology, University of Pennsylvania, B6 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104
Harry Quon, MD
- Department of Radiation Oncology, University of Pennsylvania, B6 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104
Sumei Wang, MD
- Department of Radiology, University of Pennsylvania, B6 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104
Faith Mutale, MSN, CRNP
- Department of Hematology/Oncology, University of Pennsylvania, B6 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104
Gregory Weinstein, MD
- Department of Otolaryngology, University of Pennsylvania, B6 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104
Edward J. Delikatny, PhD
- Department of Radiology, University of Pennsylvania, B6 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104
Harish Poptani, PhD
- Department of Radiology, University of Pennsylvania, B6 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104
- Address correspondence to: H.P.

Received 12 March 2009; accepted 1 June 2009. published online 16 July 2009.

Rationale and Objectives

Phosphorous magnetic resonance spectroscopy (³¹P MRS) has been used to evaluate and predict treatment response in squamous cell carcinoma of the head and neck (HNSCC). Several studies have also shown the potential of proton MRS (¹H MRS) in assessing response in HNSCC. In view of the inherent limitations associated with performing ³¹P MRS in clinical settings, the current study was performed to explore whether ¹H MRS could provide similar or complementary metabolic information in HNSCC.

Materials and Methods

Fifteen patients with HNSCC underwent pretreatment magnetic resonance imaging. Both ¹H MRS and ³¹P MRS were performed on viable solid parts of the metastatic lymph nodes of these patients. Peak areas of total choline (tCho) and unsuppressed water as observed on ¹H MRS and phosphomonoester (PME) and β-nucleotide triphosphate (β-NTP) on ³¹P MRS were computed. Pearson's correlation coefficient was used to correlate the tCho/water and PME/β-NTP ratios.

Results

In all patients, the metastatic nodes appeared hyperintense on T2-weighted images and hypointense on T1-weighted images with variable signal intensity. A prominent resonance of tCho on ¹H MRS and a resonance of PME on ³¹P MRS from the metastatic nodes of all patients were observed. A moderate correlation of 0.31 was observed between tCho/water and PME/β-NTP (P > .05).

Conclusions

The biochemical pathways involved in ¹H MRS of tCho may be different from the phospholipid metabolites seen on ³¹P MRS of head and neck cancers, and thus the two MRS techniques may be complementary to each other.

Key Words: Squamous cell carcinoma of the head and neck, phosphorous MR spectroscopy, proton MR spectroscopy, phosphomonoester, choline