The Choline/Creatine Ratio in Five Benign Neoplasms: Comparison with Squamous Cell Carcinoma by Use of in Vitro MR Spectroscopy

• Published in: American journal of neuroradiology : AJNR Vol. 21; no. 10; pp. 1930 - 1935
• Main Authors: Maheshwari, Shailendra R, Mukherji, Suresh K, Neelon, Brian, Schiro, Sharon, Fatterpekar, Girish M, Stone, Jeffrey A, Castillo, Mauricio
• Format: Journal Article
• Language: English
• Published: Oak Brook, IL Am Soc Neuroradiology 01-11-2000; American Society of Neuroradiology
• Subjects: Area Under Curve; Biological and medical sciences; Carcinoma, Squamous Cell - metabolism; Carcinoma, Squamous Cell - pathology; Choline - metabolism; Creatine - metabolism; Diagnosis, Differential; Gastrointestinal Neoplasms - metabolism; Gastrointestinal Neoplasms - pathology; Head and Neck; Humans; Magnetic Resonance Spectroscopy; Medical sciences; Muscles - metabolism; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; Prospective Studies; Statistics, Nonparametric; Tumors; Human; Squamous cell carcinoma; Choline; Head and neck; ENT disease; NMR spectrometry; Malignant tumor; Benign neoplasm; Creatine; In vitro; Differential diagnostic
• ISSN: 0195-6108; 1936-959X

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.
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.
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.
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.