Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Star-Lack, J. M. Articles by Spielman, D. M. Search for Related Content PubMed PubMed Citation Articles by Star-Lack, J. M. Articles by Spielman, D. M.

American Journal of Neuroradiology 21:183-193 (1 2000)
© 2000 American Society of Neuroradiology

ARTICLE

In Vivo ¹H MR Spectroscopy of Human Head and Neck Lymph Node Metastasis and Comparison with Oxygen Tension Measurements

Josh M. Star-Lack^a, Eifar Adalsteinsson^a, Markus F. Adam^a, David J. Terris^a, Harlan A. Pinto^a, J. Martin Brown^a and Daniel M. Spielman^,a

^a From the Lucas MRS Imaging Center (J.S.L., E.A., D.M.S.), Department of Radiology, the Department of Radiation Oncology/Division of Radiation Biology (M.F.A., J.M.B.), the Division of Otolaryngology/Head and Neck Surgery (D.J.T.), and the Department of Veterans Affairs Palo Alto Health Care System and Oncology Division Department of Medicine (H.A.P.), Stanford University, Stanford, CA.

BACKGROUND AND PURPOSE: Current diagnostic methods for head and neck metastasis are limited for monitoring recurrence and assessing oxygenation. ¹H MR spectroscopy (¹H MRS) provides a noninvasive means of determining the chemical composition of tissue and thus has a unique potential as a method for localizing and characterizing cancer. The purposes of this investigation were to measure ¹H spectral intensities of total choline (Cho), creatine (Cr), and lactate (Lac) in vivo in human lymph node metastases of head and neck cancer for comparison with normal muscle tissue and to examine relationships between metabolite signal intensities and tissue oxygenation status.

METHODS: Volume-localized Lac-edited MRS at 1.5 T was performed in vivo on the lymph node metastases of 14 patients whose conditions were untreated and who had primary occurrences of squamous cell carcinoma. MRS measurements were acquired also from the neck muscle tissue of six healthy volunteers and a subset of the patients. Peak areas of Cho, Cr, and Lac were calculated. Tissue oxygenation (pO₂) within the abnormal lymph nodes was measured independently using an Eppendorf polarographic oxygen electrode.

RESULTS: Cho:Cr ratios were significantly higher in the nodes than in muscle tissue (node Cho:Cr = 2.9 ± 1.6, muscle Cho:Cr = 0.55 ± 0.21, P = .0006). Lac was significantly higher in cancer tissue than in muscle (P = .01) and, in the nodes, showed a moderately negative correlation with median pO₂ (r = -.76) over a range of approximately 0 to 30 mm Hg. Nodes with oxygenation values less than 10 mm Hg had approximately twice the Lac signal intensity as did nodes with oxygenation values greater than 10 mm Hg (P = .01). Cho signal intensity was not well correlated with pO₂ (r = -.46) but seemed to decrease at higher oxygenation levels (>20 mm Hg).

CONCLUSION: ¹H MRS may be useful for differentiating metastatic head and neck cancer from normal muscular tissue and may allow for the possibility of assessing oxygenation. Potential clinical applications include the staging and monitoring of treatment.

This article has been cited by other articles:

				N. M. Zahr, D. Mayer, A. Pfefferbaum, and E. V. Sullivan Low Striatal Glutamate Levels Underlie Cognitive Decline in the Elderly: Evidence from In Vivo Molecular Spectroscopy Cereb Cortex, October 1, 2008; 18(10): 2241 - 2250. [Abstract] [Full Text] [PDF]

				Q. Yu, J. Yang, and P. Wang Malignant Tumors and Chronic Infections in the Masticator Space: Preliminary Assessment with In Vivo Single-Voxel 1H-MR Spectroscopy AJNR Am. J. Neuroradiol., April 1, 2008; 29(4): 716 - 719. [Abstract] [Full Text] [PDF]

				T. Bartsch, K. Alfke, S. Wolff, A. Rohr, O. Jansen, and G. Deuschl Focal MR spectroscopy of hippocampal CA-1 lesions in transient global amnesia Neurology, March 25, 2008; 70(13): 1030 - 1035. [Abstract] [Full Text] [PDF]

				A. D. King, D. K. W. Yeung, A. T. Ahuja, G. M. K. Tse, H. Y. Yuen, K. T. Wong, and A. C. van Hasselt Salivary Gland Tumors at in Vivo Proton MR Spectroscopy Radiology, November 1, 2005; 237(2): 563 - 569. [Abstract] [Full Text] [PDF]

				A. D. King, D. K.W. Yeung, A. T. Ahuja, S.F. Leung, G. M.K. Tse, and A. C. van Hasselt In Vivo Proton MR Spectroscopy of Primary and Nodal Nasopharyngeal Carcinoma AJNR Am. J. Neuroradiol., March 1, 2004; 25(3): 484 - 490. [Abstract] [Full Text] [PDF]

				K. L. Zakian, A. Shukla-Dave, P. Meyers, R. Gorlick, J. Healey, H. T. Thaler, A. G. Huvos, D. M. Panicek, and J. A. Koutcher Identification of Prognostic Markers in Bone Sarcomas Using Proton-Decoupled Phosphorus Magnetic Resonance Spectroscopy Cancer Res., December 15, 2003; 63(24): 9042 - 9047. [Abstract] [Full Text] [PDF]