title: High-field MRS in clinical drug development.
abstract: BACKGROUND
  Magnetic resonance spectroscopy (MRS) will continue to play an ever increasing role in drug discovery because MRS does readily define biomarkers for several hundreds of clinically distinct diseases. Published evidence based medicine (EBM) surveys, which generally conclude the opposite, are seriously flawed and do a disservice to the field of drug discovery.
  
  
  METHODS
  This article presents MRS and how it has guided several hundreds of practical human 'drug discovery' endeavors since its development. Specifically, the author looks at the process of 'reverse-translation' and its influence in the expansion of the number of preclinical drug discoveries from in vivo MRS. The author also provides a structured approach of eight criteria, including EBM acceptance, which could potentially re-open the field of MRS for productive exploration of existing and repurposed drugs and cost-effective drug-discovery.
  
  
  CONCLUSIONS
  MRS-guided drug discovery is poised for future expansion. The cost of clinical trials has escalated and the use of biomarkers has become increasingly useful in improving patient selection for drug trials. Clinical MRS has uncovered a treasure-trove of novel biomarkers and clinical MRS itself has become better standardized and more widely available on 'routine' clinical MRI scanners. When combined with available new MRI sequences, MRS can provide a 'one stop shop' with multiple potential outcome measures for the disease and the drug in question.
authors.affiliation: Huntington Medical Research Institutes, Magnetic Resonance Spectroscopy Unit, 10 Pico Street, Pasadena 91105, USA. bdross.hmri@gmail.com
authors.forename: Brian D
authors.initials: BD
authors.lastname: Ross
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D002986:Clinical Trials as Topic / Q000191:economics / Q000379:methods / Q000592:standards; D015195:Drug Design; D055808:Drug Discovery; D004353:Drug Evaluation, Preclinical / Q000191:economics / Q000379:methods*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000191:economics / Q000379:methods*
chemical_list: D015415:Biomarkers