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Monitoring of treatment response after chemoradiotherapy for head and neck cancer using in vivo 1H MR spectroscopy

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Abstract

Elevated choline (Cho) level has been documented on proton magnetic resonance spectroscopy (1H MRS) in head and neck squamous cell carcinoma and therefore percentage changes in Cho levels after chemoradiotherapy may serve as a marker of residual cancer in a post-treatment mass (PTM). Forty-six patients underwent 1H MRS before treatment and the 30 patients with a PTM underwent repeat 1H MRS at 6 weeks post-treatment. The percentage change in Cho/creatine and Cho/water ratios were correlated with residual cancer. The mean pretreatment Cho/creatine and Cho/water ratios were 2.24 and 1.20 × 10−3, respectively. Cho persisted in four out of nine PTMs with residual cancer. Cho was absent in five out of nine PTMs with residual cancer and 21/21 PTMs without cancer. The number of PTMs with persistent Cho was too small to allow analysis of percentage change in ratios but the presence of Cho in a PTM showed significant correlation with residual cancer (p = 0.0046), producing a sensitivity, specificity, positive predictive value and negative predictive value of 44%, 100%, 100% and 81%, respectively. Therefore, the presence of Cho in a PTM may serve as a marker of residual cancer. Furthermore since so few PTMs contain Cho, a percentage change in Cho ratios may not be a useful method for monitoring treatment response.

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Acknowledgement

The work described in this study was fully supported by a grant from the Research Grants Council of the Hong Kong Special Administrative Region, China (Project number 4300/04).

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Authors and Affiliations

  1. Department of Diagnostic Radiology and Organ Imaging, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, 30–32 Ngai Shing Street, New Territories, Hong Kong S.A.R., China

    Ann D. King, David K. W. Yeung, Kunwar S. Bhatia, Jeffrey K. T. Wong & Anil T. Ahuja

  2. Department of Clinical Oncology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, 30–32 Ngai Shing Street, New Territories, Hong Kong S.A.R., China

    Kwok-hung Yu & Frankie K. F. Mo

  3. Shenzhen Fifth Hospital and Luo-hu District Hospital, Shenzhen, Guang-dong Province, China

    Chen-wen Hu

  4. Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, 30–32 Ngai Shing Street, New Territories, Hong Kong S.A.R., China

    Gary M. K. Tse

  5. Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, 30–32 Ngan Shing Street, New Territories, Hong Kong S.A.R., China

    Alexander C. Vlantis

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  1. Ann D. King
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  2. David K. W. Yeung
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  5. Chen-wen Hu
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  6. Kunwar S. Bhatia
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  7. Gary M. K. Tse
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  8. Alexander C. Vlantis
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  9. Jeffrey K. T. Wong
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  10. Anil T. Ahuja
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Correspondence to Ann D. King.

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King, A.D., Yeung, D.K.W., Yu, Kh. et al. Monitoring of treatment response after chemoradiotherapy for head and neck cancer using in vivo 1H MR spectroscopy. Eur Radiol 20, 165–172 (2010). https://doi.org/10.1007/s00330-009-1531-2

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  • DOI: https://doi.org/10.1007/s00330-009-1531-2

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