MR spectroscopic imaging: principles and recent advances.

MR spectroscopic imaging (MRSI) has become a valuable tool for quantifying metabolic abnormalities in human brain, prostate, breast and other organs. It is used in routine clinical imaging, particularly for cancer assessment, and in clinical research applications. This article describes basic principles of commonly used MRSI data acquisition and analysis methods and their impact on clinical applications. It also highlights technical advances, such as parallel imaging and newer high-speed MRSI approaches that are becoming viable alternatives to conventional MRSI methods. Although the main focus is on (1) H-MRSI, the principles described are applicable to other MR-compatible nuclei. This review of the state-of-the-art in MRSI methodology provides a framework for critically assessing the clinical utility of MRSI and for defining future technical development that is expected to lead to increased clinical use of MRSI. Future technical development will likely focus on ultra-high field MRI scanners, novel hyperpolarized contrast agents using metabolically active compounds, and ultra-fast MRSI techniques because these technologies offer unprecedented sensitivity and specificity for probing tissue metabolic status and dynamics.