ABSTRACT
Although conventional magnetic resonance (MR) imaging with T1, T2, and gadolinium
enhancement is the primary modality used for characterizing musculoskeletal lesions,
its specificity for distinguishing malignancy from nonmalignant tissue remains low.
Proton MR spectroscopy (MRS) is a new approach to the evaluation of musculoskeletal
lesions that offers a method of metabolic imaging with MR. With proton MRS, a footprint
of metabolite concentration in a region of interest can be obtained and markers for
malignancy can be detected, such as elevated concentrations of the metabolite choline.
Proton MRS is one of the most promising noninvasive techniques available for molecular
identification of malignant tumor markers. However, the role of MRS in the assessment
of musculoskeletal tumors remains in its infancy. In this article, we discuss the
technical aspects of performing proton MRS, including differences between single voxel
and multivoxel technique and its advantages and limitations. We demonstrate its potential
utility in the evaluation of musculoskeletal lesions through a series of examples.
KEYWORDS
Neoplasm - bone - soft tissue - MR spectroscopy
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Laura M FayadM.D.
Department of Radiology and Orthopaedic Surgery, Johns Hopkins Medical Institutions
601 N. Wolfe St., Baltimore, MD 21287
Email: lfayad1@jhmi.edu
