In vivo magnetic resonance spectroscopy of cancer

Magnetic resonance (MR) methods provide anatomical, physiological and metabolic assessment of the cancer non-invasively. In vivo MR spectroscopy (MRS) provides information on endogenous metabolites present in tissues which is useful not only for diagnosis but also for monitoring the tumor response to therapy. Technical developments in field of in vivo MRS have resulted in mapping spatial distribution of metabolites (spectroscopic imaging), improvement in spectral sensitivity and resolution, and determination of absolute concentration of metabolites. The localized proton MRS first reported two decades ago has now emerged as a non-invasive methodology, to be used in clinical settings for the evaluation of brain and other tumors. The method has shown tremendous potential in the assessment of cancer of different organs, notably, in brain, breast and prostate cancers. Recent developments in MRS technology has made possible to expand its application to other malignancies such as musculoskeletal system, head and neck, and liver. In this review we briefly summarize the potential applications of MRS in diagnosis, staging, monitoring treatment, guiding biopsies and prediction of malignancy in brain, breast and prostate cancers. We also present briefly the current status and limitations of the applications of MRS in musculoskeletal system and liver, as two examples.