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Levels of choline‐containing compounds in normal liver and liver metastases of colorectal cancer as recorded by 1 H MRS
Author(s) -
Voert Edwin E.G.W.,
Heijmen Linda,
Asten Jack J.A.,
Wright Alan J.,
Nagtegaal Iris D.,
Punt Cornelis J.A.,
Wilt Johannes H.W.,
Laarhoven Hanneke W.M.,
Heerschap Arend
Publication year - 2019
Publication title -
nmr in biomedicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.278
H-Index - 114
eISSN - 1099-1492
pISSN - 0952-3480
DOI - 10.1002/nbm.4035
Subject(s) - repeatability , choline , nuclear medicine , colorectal cancer , medicine , voxel , effective diffusion coefficient , nuclear magnetic resonance , cancer , magnetic resonance imaging , chemistry , pathology , radiology , physics , chromatography
Purpose A relatively high signal for choline‐containing compounds (total choline, tCho) is commonly found in 1 H MR spectra of malignant tumors, but it is unclear if this also occurs in tumors in the liver. We evaluated the potential of the tCho signal in single voxel 1 H MR spectra of the human liver to assess metastases of colorectal cancers. Experiment MR spectra of an 8 cm 3 PRESS‐localized voxel were obtained at 3 T from the livers of 12 healthy volunteers and from metastatic lesions in 20 patients in two different sessions. To correct for motion artifacts, sequentially recorded spectra were individually phased and frequency aligned before averaging. Spectra were analyzed using LCModel and tissue levels estimated by water referencing. Repeatability was assessed with Bland–Altman analyses. To estimate tumor necrosis, diffusion‐weighted imaging of the liver was performed. High resolution magic angle spinning (HRMAS) spectra of tumor and normal liver samples were obtained at 11.7 T. Results With increasing tumor volumes, tCho levels decreased, indicating a partial volume effect. Mean tCho content in tumors larger than the PRESS voxel (>8 cm 3 ) was significantly lower ( p < 0.01) than for normal liver: 1.6 (range 0.0–3.4) versus 6.9 (range 4.9–11.1) mmol/kg wet weight, while it was comparable for tumors smaller than 8 cm 3 : 7.0 (range 3.8–9.3) mmol/kg. The higher 90th percentile apparent diffusion coefficient value in the larger lesions indicates more necrosis. Measurement repeatability was average in normal livers and poor in tumors. HRMAS did not show substantial differences in choline‐containing compounds between normal liver and metastasis. Conclusion An increased tCho content was not observed in 1 H MR spectra of liver metastasis of colorectal cancer, compared with normal liver. This may be due to the background of a high tCho signal in spectra of normal liver or to an intrinsic lower tCho content in these tumors, but is most likely the result of necrosis in metastatic tumor tissue.