Multivoxel magnetic resonance spectroscopy of brain tumors

Magnetic resonance spectroscopy (MRS) is becoming more widely available for clinical applications and is able to provide information about the metabolic properties of regions of normal and abnormal tissue morphology. A critical question for the clinical management of patients with brain tumors is whether multivoxel MRS is able to add new information to the high-quality anatomical data provided by conventional MR imaging techniques and whether this information is relevant for the diagnosis and clinical management of such patients. In this article, the state of the art for acquiring and analyzing multivoxel MRS data is reviewed and placed in context relative to imaging findings for metastatic and primary brain tumors. The MRS data are seen to provide unique information that when combined with high-quality anatomical MR images has implications for defining tumor type and grade, directing biopsy or surgical resection, planning focal radiation or biological therapies, and understanding the mechanisms of success and failure of new treatments.