European Radiology

, Volume 19, Issue 8, pp 2041–2048 | Cite as

Epithelial and stromal metabolite changes in the transition from cervical intraepithelial neoplasia to cervical cancer: an in vivo 1H magnetic resonance spectroscopic imaging study with ex vivo correlation

  • Sonali S. De Silva
  • Geoffrey S. Payne
  • Veronica A. Morgan
  • Thomas E. J. Ind
  • John H. Shepherd
  • Desmond P. J. Barton
  • Nandita M. deSouzaEmail author
Magnetic Resonance


To investigate epithelial and stromal metabolite changes in cervical intraepithelial neoplasia (CIN) and cervical cancer in vivo and correlate findings with MR spectroscopy of tissue samples. Forty-seven women (19 with CIN, 28 with cervical cancer) underwent endovaginal MR at 1.5 T with T2-W and localised 2D MR spectroscopic imaging (PRESS, TR = 1,500 ms, TE = 135 ms). tCho, 2 ppm and -CH2 lipid peaks were measured in epithelial (>50% epithelium, no tumour), stromal (>50% stroma, no tumour) and tumour (>30% tumour) voxels. Unsuppressed water signal from the same voxel provided a concentration reference. 1H HR-MAS MR spectra were acquired from tissue in 37 patients (11.74 T, pulse-acquire and cpmg sequences, with water pre-saturation). Analysable data from 17 CIN and 25 cancer patients showed significant increases in tCho (p = 0.03) and 2 ppm (p = 0.007) in tumour compared with epithelial voxels from CIN patients, but not with epithelial voxels from cancer patients. No significant differences were seen in stroma from cancer compared with CIN patients. Differences in -CH2 lipids were not significant between groups. There was no significant correlation between in vivo and ex vivo tCho or -CH2 lipids. Estimated in vivo concentrations of tCho and 2 ppm resonances increase in tumour and adjacent epithelium in progression from CIN to cervical cancer.


Cervical cancer 1H MR spectroscopy Cervical intraepithelial neoplasia Choline Mobile lipid resonances 



This study was supported by Cancer Research UK (CUK) grant numbers C1353/A5408 and C1060/A808. We thank Mr. Paul Carter, Mr. Norman McWhinney, Mr. Mike Katesmark, Ms. Jane Bridges and Mr. David Milliken for their assistance with patient recruitment and sample collection and Dr. Valerie Thomas for her assistance with histopathology. We are grateful to nurses and medical staff at St George’s Hospital, Epsom and St. Helier Hospitals and at The Royal Marsden Hospital, for their support.


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Copyright information

© European Society of Radiology 2009

Authors and Affiliations

  • Sonali S. De Silva
    • 1
  • Geoffrey S. Payne
    • 1
  • Veronica A. Morgan
    • 1
  • Thomas E. J. Ind
    • 2
  • John H. Shepherd
    • 2
  • Desmond P. J. Barton
    • 2
  • Nandita M. deSouza
    • 1
    • 3
    Email author
  1. 1.Cancer Research UK Clinical Magnetic Resonance Research GroupInstitute of Cancer Research and Royal Marsden NHS Foundation TrustSuttonUK
  2. 2.Department of Gynaecological SurgeryRoyal Marsden NHS Foundation TrustLondonUK
  3. 3.CR UK Clinical Magnetic Resonance Research GroupInstitute of Cancer Research and Royal Marsden NHS Foundation TrustSuttonUK

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