title: Proton MR spectroscopy in metabolic assessment of musculoskeletal lesions.
abstract: OBJECTIVE
  The purposes of this review are to describe the principles and method of MR spectroscopy, summarize current published data on musculoskeletal lesions, and report additional cases that have been analyzed with recently developed quantitative methods.
  
  
  CONCLUSIONS
  Proton MR spectroscopy can be used to identify key tissue metabolites and may serve as a useful adjunct to radiographic evaluation of musculoskeletal lesions. A pooled analysis of 122 musculoskeletal tumors revealed that a discrete choline peak has a sensitivity of 88% and specificity of 68% in the detection of malignancy. Modest improvements in diagnostic accuracy in 22 of 122 cases when absolute choline quantification was used encourage the pursuit of development of choline quantification methods.
authors.affiliation: Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, 601 N Caroline St, Baltimore, MD 21287, USA. tsubhaw1@jhmi.edu
authors.forename: Ty K
authors.initials: TK
authors.lastname: Subhawong
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Durand
authors.forename: Michael A
authors.initials: MA
authors.lastname: Jacobs
authors.forename: John A
authors.initials: JA
authors.lastname: Carrino
authors.forename: Antonio J
authors.initials: AJ
authors.lastname: Machado
authors.forename: Laura M
authors.initials: LM
authors.lastname: Fayad
mesh_terms: D000465:Algorithms; D014408:Biomarkers, Tumor / Q000378:metabolism; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000378:metabolism*; D002794:Choline / Q000378:metabolism*; D003287:Contrast Media; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D019042:Muscle Neoplasms / Q000175:diagnosis* / Q000378:metabolism*; D011522:Protons; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D003287:Contrast Media; D011522:Protons; D002794:Choline