Proton and Phosphorous MR Spectroscopy in Squamous Cell Carcinomas of the Head and Neck

Sanjeev Chawla, Sungheon Kim, Laurie A. Loevner, Harry Quon, Sumei Wang, Faith Mutale, Gregory Weinstein, Edward J. Delikatny, Harish Poptani

Research output: Contribution to journalArticlepeer-review


Rationale and Objectives: Phosphorous magnetic resonance spectroscopy (31P MRS) has been used to evaluate and predict treatment response in squamous cell carcinoma of the head and neck (HNSCC). Several studies have also shown the potential of proton MRS (1H MRS) in assessing response in HNSCC. In view of the inherent limitations associated with performing 31P MRS in clinical settings, the current study was performed to explore whether 1H MRS could provide similar or complementary metabolic information in HNSCC. Materials and Methods: Fifteen patients with HNSCC underwent pretreatment magnetic resonance imaging. Both 1H MRS and 31P MRS were performed on viable solid parts of the metastatic lymph nodes of these patients. Peak areas of total choline (tCho) and unsuppressed water as observed on 1H MRS and phosphomonoester (PME) and β-nucleotide triphosphate (β-NTP) on 31P MRS were computed. Pearson's correlation coefficient was used to correlate the tCho/water and PME/β-NTP ratios. Results: In all patients, the metastatic nodes appeared hyperintense on T2-weighted images and hypointense on T1-weighted images with variable signal intensity. A prominent resonance of tCho on 1H MRS and a resonance of PME on 31P MRS from the metastatic nodes of all patients were observed. A moderate correlation of 0.31 was observed between tCho/water and PME/β-NTP (P > .05). Conclusions: The biochemical pathways involved in 1H MRS of tCho may be different from the phospholipid metabolites seen on 31P MRS of head and neck cancers, and thus the two MRS techniques may be complementary to each other.

Original languageEnglish (US)
Pages (from-to)1366-1372
Number of pages7
JournalAcademic radiology
Issue number11
StatePublished - Nov 2009
Externally publishedYes


  • Squamous cell carcinoma of the head and neck
  • choline
  • phosphomonoester
  • phosphorous MR spectroscopy
  • proton MR spectroscopy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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