Choline peak

A.Prof Frank Gaillard et al.

Choline is a precursor of acetylcholine (ACH), a component of cell membranes which is commonly examined in MR spectroscopy. It resonates at 3.2 ppm chemical shift.

Choline is a marker of cellular membrane turnover and therefore elevated in neoplasms, demyelination, inflammation and gliosis 1.

It is useful in a number of scenarios: 

  • diffuse glioma vs. metastasis: elevation in a region of high T2 signal surrounding an enhancing mass (edema) suggests an infiltrating diffuse glioma rather than a cerebral metastasis
  • GBM progression vs. pseudoprogression: elevation favors tumor progression over pseudoprogression, but can be elevated if a strong immune response is present as is seen in immunotherapy 1,2
MR spectroscopy
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rID: 27823
Tag: refs
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Cases and figures

  • Case 1: low-grade glioma
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    Case 2: primary CNS lymphoma
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