Prediction of treatment response of head and neck cancers with P-31 MR spectroscopy from pretreatment relative phosphomonoester levels.
OBJECTIVE
Combinations of chemotherapy and fractionated radiation therapy are the currently preferred nonsurgical treatment methods for squamous cell carcinoma of the head and neck, but to the authors' knowledge there is no reliable marker for predicting therapeutic response. Early identification of nonresponders would allow prompt replacement of ineffective, toxic therapy by alternative, potentially more effective procedures. Frequent regional node involvement facilitates surface coil investigation with phosphorus-31 magnetic resonance spectroscopy.


METHODS
P-31 magnetic resonance spectra were acquired from 12 patients before radiation therapy or chemotherapy. In vivo three-dimensional localized P-31 nuclear magnetic resonance chemical shift imaging was performed with a 1.5-T clinical imager and a dual-tuned H-1/P-31 surface coil. Proton decoupling and nuclear Overhauser enhancement were used to improve sensitivity and resolve overlapping signals in the phosphomonoester region of the spectrum.


RESULTS
The average pretreatment ratio of phosphomonoester to beta-nucleoside triphosphate was significantly smaller in complete responders (n = 4) than in incomplete responders (partial responders plus nonresponders, n = 8) (0.0 +/- 0.0 vs 1.22 +/- 0.17 [P = .004]).


CONCLUSIONS
Results of this preliminary study suggest that H-1-decoupled P-31 magnetic resonance spectroscopy may prove to be a useful predictor of therapeutic response in head and neck cancers.
Shukla-Dave
Amita
A
Dept of Radiology, University of Pennsylvania Medical Center, Philadelphia, USA.
Poptani
Harish
H
Loevner
Laurie A
LA
Mancuso
Anthony
A
Serrai
Hacene
H
Rosenthal
David I
DI
Kilger
Alexandra M
AM
Nelson
David S
DS
Zakian
Kristen L
KL
Arias-Mendoza
Fernando
F
Rijpkema
Mark
M
Koutcher
Jason A
JA
Brown
Truman R
TR
Heerschap
Arend
A
Glickson
Jerry D
JD
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000737:chemistry / Q000175:diagnosis* / Q000628:therapy; D003131:Combined Modality Therapy; D004952:Esters / Q000032:analysis*; D005260:Female; D006258:Head and Neck Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000737:chemistry / Q000175:diagnosis; D009705:Nucleosides / Q000032:analysis*; D016896:Treatment Outcome
D004952:Esters; D009705:Nucleosides