Magnetic resonance spectroscopy — Revisiting the biochemical and molecular milieu of brain tumors

• Magnetic resonance spectroscopy is an established technology for non-invasive assessment of pathological tissue.
• Good understanding of the physical principles of the technique can help one exploit it maximally.
• An array of information from the technique is available and needs deep understanding of the results.
• Newer variations of this technology are being invented to evaluate different aspects of pathologies in a more refined manner.
• We also discuss the limitations of this technology and possible solutions there-off.

BackgroundMagnetic resonance spectroscopy (MRS) is an established tool for in-vivo evaluation of the biochemical basis of human diseases. On one hand, such lucid depiction of ‘live biochemistry’ helps one to decipher the true nature of the pathology while on the other hand one can track the response to therapy at sub-cellular level. Brain tumors have been an area of continuous interrogation and instigation for mankind. Evaluation of these lesions by MRS plays a crucial role in the two aspects of disease management described above.Scope of reviewPresented is an overview of the window provided by MRS into the biochemical aspects of brain tumors. We systematically visit each metabolite deciphered by MRS and discuss the role of deconvoluting the biochemical aspects of pathologies (here in context of brain tumors) in the disease management cycle. We further try to unify a radiologist's perspective of disease with that of a biochemist to prove the point that preclinical work is the mother of the treatment we provide at bedside as clinicians. Furthermore, an integrated approach by various scientific experts help resolve a query encountered in everyday practice.Major conclusionsMR spectroscopy is an integral tool for evaluation and systematic follow-up of brain tumors. A deeper understanding of this technology by a biochemist would help in a swift and more logical development of the technique while a close collaboration with radiologist would enable definitive application of the same.General significanceThe review aims at inciting closer ties between the two specialists enabling a deeper understanding of this valuable technology.