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HEAD AND NECK

In Vivo Proton MR Spectroscopy of Primary and Nodal Nasopharyngeal Carcinoma

Ann D. Kinga, David K.W. Yeungb, Anil T. Ahujaa, S.F. Leungb, Gary M.K. Tsec and Andrew C. van Hasseltd

a Department of Diagnostic Radiology & Organ Imaging, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, Special Administrative Region, China
b Department of Clinical Oncology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, Special Administrative Region, China
c Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, Special Administrative Region, China
d Department of Surgery Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, Special Administrative Region, China

Address reprint requests to A.D. King, Department of Diagnostic Radiology and Organ Imaging, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, Special Administrative Region, China

BACKGROUD AND PURPOSE: The aim of this study was to determine the feasibility of performing in vivo proton (1H) MR spectroscopy of nasopharyngeal carcinoma (NPC) and to document the 1H spectrum of this cancer.

METHODS: Twenty-seven patients with NPC lesions >1 cm3 underwent localized 1H MR spectroscopy performed at 1.5 T. Water-suppressed spectra from both primary tumors (nine cases) and metastatic nodes (18 cases) were obtained at TE 136 and 272. Spectra were analyzed in the time domain by using a nonlinear least squares fitting algorithm with incorporation of previous knowledge. Choline (Cho)/creatine (Cr) ratios for primary NPC and metastatic nodes were calculated and compared. Spectra from normal neck muscle of five volunteers were acquired as control data.

RESULTS: 1H MR spectroscopy was successfully obtained in seven (78%) of nine primary tumors and 16 (89%) of 18 metastatic nodes. Intense lipid signals in the range of 0.89 to 2.02 ppm were observed in 95% of spectra at TE 136 and 91% of spectra at TE 272. At TE 136, Cho/Cr for metastatic nodes (5.3 ± 1.6) was significantly higher than the ratio for primary (2.6 ± 0.5) NPC lesions (P = .02). Cho/Cr ratios for NPC lesions were higher than those for normal neck muscles, for which values ranged from 0 to 0.97 and 0 to 1.1 at TE 136 and 272, respectively.

CONCLUSION: 1H MR spectroscopy is a feasible technique for the evaluation of NPC tumors >1 cm3. Cho/Cr ratios for the lesions were high compared with those for normal neck muscle.




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