In vivo proton MR spectroscopy of primary and nodal nasopharyngeal carcinoma

BACKGROUND AND PURPOSE: The aim of this study was to determine the feasibility of performing in vivo proton ((1)H) MR spectroscopy of nasopharyngeal carcinoma (NPC) and to document the (1)H spectrum of this cancer. METHODS: Twenty-seven patients with NPC lesions >1 cm(3) underwent localized (1)H MR spectroscopy performed at 1.5 T. Water-suppressed spectra from both primary tumors (nine cases) and metastatic nodes (18 cases) were obtained at TE 136 and 272. Spectra were analyzed in the time domain by using a nonlinear least squares fitting algorithm with incorporation of previous knowledge. Choline (Cho)/creatine (Cr) ratios for primary NPC and metastatic nodes were calculated and compared. Spectra from normal neck muscle of five volunteers were acquired as control data. RESULTS: (1)H MR spectroscopy was successfully obtained in seven (78%) of nine primary tumors and 16 (89%) of 18 metastatic nodes. Intense lipid signals in the range of 0.89 to 2.02 ppm were observed in 95% of spectra at TE 136 and 91% of spectra at TE 272. At TE 136, Cho/Cr for metastatic nodes (5.3 +/- 1.6) was significantly higher than the ratio for primary (2.6 +/- 0.5) NPC lesions (P =.02). Cho/Cr ratios for NPC lesions were higher than those for normal neck muscles, for which values ranged from 0 to 0.97 and 0 to 1.1 at TE 136 and 272, respectively. CONCLUSION: (1)H MR spectroscopy is a feasible technique for the evaluation of NPC tumors >1 cm(3). Cho/Cr ratios for the lesions were high compared with those for normal neck muscle.