TY - JOUR
T1 - Levels of choline-containing compounds in normal liver and liver metastases of colorectal cancer as recorded by 1H MRS
AU - ter Voert, Edwin E. G. W.
AU - Heijmen, Linda
AU - van Asten, Jack J. A.
AU - Wright, Alan J.
AU - Nagtegaal, Iris D.
AU - Punt, Cornelis J. A.
AU - de Wilt, Johannes H. W.
AU - van Laarhoven, Hanneke W. M.
AU - Heerschap, Arend
PY - 2019
Y1 - 2019
N2 - Purpose: A relatively high signal for choline-containing compounds (total choline, tCho) is commonly found in 1H 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 1H MR spectra of the human liver to assess metastases of colorectal cancers. Experiment: MR spectra of an 8 cm3 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 cm3) 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 cm3: 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 1H 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.
AB - Purpose: A relatively high signal for choline-containing compounds (total choline, tCho) is commonly found in 1H 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 1H MR spectra of the human liver to assess metastases of colorectal cancers. Experiment: MR spectra of an 8 cm3 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 cm3) 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 cm3: 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 1H 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.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85056793039&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30457686
U2 - https://doi.org/10.1002/nbm.4035
DO - https://doi.org/10.1002/nbm.4035
M3 - Article
C2 - 30457686
SN - 0952-3480
VL - 32
JO - NMR in biomedicine
JF - NMR in biomedicine
IS - 1
M1 - e4035
ER -