Martin Wilson, University of Birmingham
Ovidiu Andronesi, Harvard Medical School
Peter B. Barker, Johns Hopkins School of Medicine
Robert Bartha, Robarts Research Institute
Alberto Bizzi, Foundation IRCCS Neurological Institute "C. Besta"
Patrick J. Bolan, University of Minnesota Medical School
Kevin M. Brindle, University of Cambridge
In Young Choi, University of Kansas Medical Center
Cristina Cudalbu, Ecole Polytechnique Fédérale de Lausanne
Ulrike Dydak, College of Health and Human Sciences
Uzay E. Emir, College of Health and Human Sciences
Ramon G. Gonzalez, Harvard Medical School
Stephan Gruber, Medizinische Universitat Wien
Rolf Gruetter, Ecole Polytechnique Fédérale de Lausanne
Rakesh K. Gupta, Fortis Memorial Research Institute
Arend Heerschap, Radboud University Nijmegen Medical Centre
Anke Henning, Max Planck Institute for Biological Cybernetics
Hoby P. Hetherington, University of Pittsburgh
Petra S. Huppi, Université de Genève
Ralph E. Hurd, Stanford Radiological Sciences Lab
Kejal Kantarci, Mayo Clinic
Risto A. Kauppinen, University of Bristol
Dennis W.J. Klomp, University Medical Center Utrecht
Roland Kreis, University of Bern
Marijn J. Kruiskamp, Philips Healthcare Nederland
Martin O. Leach, The Institute of Cancer Research, London
Alexander P. Lin, Harvard Medical School
Peter R. Luijten, University Medical Center Utrecht
Małgorzata Marjańska, University of Minnesota Medical School
Andrew A. Maudsley, University of Miami
Dieter J. Meyerhoff, University of California, San Francisco
Carolyn E. Mountford, Translation Research Institute Australia

Document Type


Publication Date



Magnetic Resonance in Medicine





First Page


Last Page


URL with Digital Object Identifier



© 2019 International Society for Magnetic Resonance in Medicine Proton MRS (1H MRS) provides noninvasive, quantitative metabolite profiles of tissue and has been shown to aid the clinical management of several brain diseases. Although most modern clinical MR scanners support MRS capabilities, routine use is largely restricted to specialized centers with good access to MR research support. Widespread adoption has been slow for several reasons, and technical challenges toward obtaining reliable good-quality results have been identified as a contributing factor. Considerable progress has been made by the research community to address many of these challenges, and in this paper a consensus is presented on deficiencies in widely available MRS methodology and validated improvements that are currently in routine use at several clinical research institutions. In particular, the localization error for the PRESS localization sequence was found to be unacceptably high at 3 T, and use of the semi-adiabatic localization by adiabatic selective refocusing sequence is a recommended solution. Incorporation of simulated metabolite basis sets into analysis routines is recommended for reliably capturing the full spectral detail available from short TE acquisitions. In addition, the importance of achieving a highly homogenous static magnetic field (B0) in the acquisition region is emphasized, and the limitations of current methods and hardware are discussed. Most recommendations require only software improvements, greatly enhancing the capabilities of clinical MRS on existing hardware. Implementation of these recommendations should strengthen current clinical applications and advance progress toward developing and validating new MRS biomarkers for clinical use.


Citation of this paper:

Wilson, M, Andronesi, O, Barker, PB, et al. Methodological consensus on clinical proton MRS of the brain: Review and recommendations. Magn Reson Med. 2019; 82: 527– 550.

Find in your library