MR Spectroscopy Interpretation

Basic Principles and Techniques

The National Comprehensive Cancer Network recommends using MR spectroscopy to assess tissue metabolites, which is valuable for tumor grading, response assessment, identifying malignant degeneration, distinguishing radiation necrosis from recurrent neoplasm, and guiding biopsy site selection 1
The choice between acquisition techniques should consider the clinical question and anatomical region of interest, with two main acquisition methods available: single voxel and multivoxel spectroscopy 1

The National Comprehensive Cancer Network found that MR spectroscopy had the highest diagnostic accuracy for treatment response evaluation in patients with high-grade glioma 1
MR spectroscopy alone has moderate diagnostic ability to differentiate glioma recurrence from radiation necrosis and should be combined with other techniques 1
In cerebrovascular disease, MR spectroscopy can detect lactate as a marker of anaerobic metabolism due to ischemia 2

Reliability is degraded by adjacent metal, blood byproducts, and bone/soft tissue/air interfaces 1
Acquisition requires expertise in technique and postprocessing 1
Spectral quality can be affected by patient movement, requiring sedation in pediatric patients 2

When evaluating treatment response, compare current spectra with baseline studies to assess metabolic changes 1

Combine MR spectroscopy with conventional MRI sequences for anatomical correlation 1
In cerebrovascular disease, MR spectroscopy can detect lactate as a marker of anaerobic metabolism due to ischemia 2