Creatine peak

Last revised by Dr Jeremy Jones on 05 May 2022

Creatine is one of the compounds examined in MR spectroscopy. It resonates at 3.0 ppm chemical shift (with a second usually smaller peak at 3.95 ppm 2).

It is found in metabolically active tissues (brain, muscle, heart), where it is important in the storage and transfer of energy. It tends to be maintained at a relatively constant level and is predominantly used as a convenient internal standard (allow for ratio calculations), although it reduces in high-grade gliomas.

Of note, it is not prominent in cerebral metastases and an absence of a creatine peak in an enhancing cerebral mass suggests metastasis over glioblastoma 1

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