Clinical experience with 13C MRS in vivo

13C MRS was installed on a clinical scanner at 1.5 T in order to facilitate integrated MR examinations of human brain disorders. Using a simplified protocol, (1-(13)C) glucose and/or (1-(13)C) acetate were administered orally or by intravenous infusion. (13)C spectra of diagnostic quality were acquired in more than 100 consecutive studies. Novel (13)C neurochemical data contributed to the understanding of Alzheimer's, Canavan's, mitochondrial and hepatic encephalopathy, epilepsy and normal brain development. (13)C MRS uncovered hitherto unknown disorders of NAA-synthesis, glutamate neurotransmission, TCA-cycle and glycolysis. Despite low inherent signal-to-noise, natural abundance (13)C MRS showed diagnostic promise. (13)C MRS is feasible in a clinical setting, at reasonable cost in neonates, children, adults and elderly patients.