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Comparative Study
. 2000 Nov-Dec;21(10):1930-5.

The choline/creatine ratio in five benign neoplasms: comparison with squamous cell carcinoma by use of in vitro MR spectroscopy

S R Maheshwari  1 , S K Mukherji, B Neelon, S Schiro, G M Fatterpekar, J A Stone, M Castillo
Affiliations
Comparative Study

The choline/creatine ratio in five benign neoplasms: comparison with squamous cell carcinoma by use of in vitro MR spectroscopy

S R Maheshwari et al. AJNR Am J Neuroradiol. 2000 Nov-Dec.

Abstract

Background and purpose: The choline (Cho)/creatine (Cr) ratio has been shown to be a reliable proton MR spectroscopy metabolic marker for differentiating squamous cell carcinoma (SCCA) from normal muscle in the upper aerodigestive tract. However, it is unclear whether the Cho/Cr ratio can be used to differentiate a malignant tumor from a benign neoplasm in the extracranial head and neck. Our purpose was to determine whether the Cho/Cr ratio can be used to differentiate benign from malignant tumors in this region.

Methods: In vitro one-dimensional proton MR spectroscopy (2,000/136,272 [TR/TE]) was performed at 11 T on tissue specimens obtained from glomus tumors (n = 3), inverting papilloma (n = 1), and schwannoma (n = 1). Cho/Cr area ratios were calculated and compared with similar, previously reported in vitro (11 T) findings and with samples of SCCA and normal muscle.

Results: The Cho/Cr ratio was elevated in relation to muscle in all benign tumors at TE = 136 (glomus tumors = 4.52, inverting papilloma = 3.85, schwannoma = 2.2) and at TE = 272 (glomus tumors = 8.01, inverting papilloma = 2.1, schwannoma = 4.28). The average Cho/Cr ratio for benign lesions was 3.92 (TE = 136) and 6.11 (TE = 272). The Cho/Cr ratio was significantly higher in benign tumors than in both SCCA and muscle. The average Cho/Cr ratio for muscle at TEs of 136 and 272 was 1.16 and 1.31, respectively, whereas for SCCA the average Cho/Cr ratio at TEs of 136 and 272 was 1.67 and 2.45, respectively.

Conclusion: In our small group, the Cho/Cr ratio was significantly higher in benign tumors than in muscle and SCCA of the extracranial head and neck.

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Figures

<sc>fig</sc> 1.
fig 1.
Inverting papilloma. In vitro 1D proton MR spectrum (2000/136/128) shows elevation of the Cho/Cr ratio. Curved arrow indicates Cho; straight arrow, Cr
<sc>fig</sc> 2.
fig 2.
Glomus tumor. In vitro 1D proton MR spectrum (2000/136/128) shows elevation of the Cho/Cr ratio. Curved arrow indicates Cho; straight arrow, Cr
<sc>fig</sc> 3.
fig 3.
Vagal schwannoma. In vitro 1D proton MR spectrum (2000/136/128) shows elevation of the Cho/Cr ratio. Curved arrow indicates Cho; straight arrow, shoulder of Cr resonance
<sc>fig</sc> 4.
fig 4.
Strap muscle. In vitro 1D proton MR spectrum (2000/136/128) shows similar areas of the Cho/Cr ratio. Curved arrow indicates Cho; straight arrow, Cr
<sc>fig</sc> 5.
fig 5.
SCCA. In vitro 1D proton MR spectrum (2000/136/128) of SCCA obtained from the same patient as in figure 3 shows elevation of the Cho/Cr ratio. Curved arrow indicates Cho; straight arrow, Cr
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