title: Prediction of treatment response in head and neck cancer by magnetic resonance spectroscopy.
abstract: OBJECTIVE
  Poor treatment outcome remains high in patients with squamous cell carcinoma (SCC) of the head and neck region. Treatment of head and neck cancer could be improved and perhaps standardized if reliable markers for tumor progression and poor prognosis could be developed. MR spectroscopy has been used previously to differentiate between malignant and adjacent normal specimen in these cancers. This study explores the capability of MR spectroscopy in providing an indication of the aggressiveness of a tumor and its response to treatment.
  
  
  METHODS
  Thirty-six SCC patients with treatment failure, and 22 other patients who were treated concurrently at the same center but with no indication of failure for a period of 3 years, were selected for the study. Tumor specimens were kept frozen at -70 degrees C, and later subjected to 1H-MR spectroscopy at 25 degrees C. The resonance areas for 6 spectral regions were determined, and their ratio calculated. The mean values of the ratios were then compared between the 2 groups by using the Student t test.
  
  
  RESULTS
  The choline-to-creatine (3.2/3.0 parts per million [ppm]) and the 1.3/0.9 ppm spectral intensity ratios (signal due to lipid or lactic acid) were the 2 most notable ones to be significantly elevated in the group with poor response. Using these ratios, a sensitivity of 83% and a specificity of 82% were obtained in predicting which head and neck cancer patients would fail treatment.
  
  
  CONCLUSIONS
  These preliminary results suggest that MR spectroscopy has the potential to contribute to an accurate and early prediction of tumor behavior and response to treatment in squamous cell carcinoma of the head and neck region.
authors.affiliation: Institute for Biodiagnostics, National Research Council, University of Manitoba, Canada.
authors.forename: Tedros
authors.initials: T
authors.lastname: Bezabeh
authors.forename: Olva
authors.initials: O
authors.lastname: Odlum
authors.forename: Richard
authors.initials: R
authors.lastname: Nason
authors.forename: Paul
authors.initials: P
authors.lastname: Kerr
authors.forename: Donna
authors.initials: D
authors.lastname: Sutherland
authors.forename: Rakesh
authors.initials: R
authors.lastname: Patel
authors.forename: Ian C P
authors.initials: IC
authors.lastname: Smith
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000737:chemistry / Q000175:diagnosis* / Q000628:therapy*; D002794:Choline / Q000032:analysis; D003401:Creatine / Q000032:analysis; D005260:Female; D006258:Head and Neck Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D019344:Lactic Acid / Q000032:analysis; D008055:Lipids / Q000032:analysis; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D017211:Treatment Failure
chemical_list: D008055:Lipids; D019344:Lactic Acid; D003401:Creatine; D002794:Choline