American Journal of Neuroradiology 21:1930-1935 (11 2000)
© 2000 American Society of Neuroradiology
ARTICLE
The Choline/Creatine Ratio in Five Benign Neoplasms: Comparison with Squamous Cell Carcinoma by Use of in Vitro MR Spectroscopy
a From the Departments of Radiology (S.R.M., S.K.M., S.S., G.M.F., J.A.S., M.C.), Surgery (S.K.M.), and Anesthesiology (S.K.M.), and the Lineberger Comprehensive Cancer Center (S.K.M., B.N.), University of North Carolina, Chapel Hill.
b Address reprint requests to Suresh K. Mukherji, MD, Department of Radiology, 3324 Old Infirmary, CB# 7510, University of North Carolina School of Medicine, Chapel Hill, NC 27599.
BACKGROUD 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 (2000/136,272 [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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