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World J Gastroenterol. Apr 7, 2010; 16(13): 1577-1586
Published online Apr 7, 2010. doi: 10.3748/wjg.v16.i13.1577
Magnetic resonance spectroscopy to study hepatic metabolism in diffuse liver diseases, diabetes and cancer
Pieter C Dagnelie, Susanne Leij-Halfwerk
Pieter C Dagnelie, Susanne Leij-Halfwerk, Department of Epidemiology, Maastricht University, 6200 MD Maastricht, The Netherlands
Author contributions: Dagnelie PC designed the paper, wrote the introduction, discussion and conclusions as well as the sections on liver metabolism in patients with diabetes and patients with a distant malignant tumor, and carried out the final editing of the manuscript; Leij-Halfwerk S co-designed and co-edited the paper and wrote the sections on MRS in diffuse and chronic liver disease, viral hepatitis and HIV, alcohol abuse, and other liver diseases.
Correspondence to: Pieter C Dagnelie, PhD, Department of Epidemiology, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
Telephone: +31-43-3882393 Fax: +31-43-3884128
Received: February 25, 2010
Revised: March 22, 2010
Accepted: March 29, 2010
Published online: April 7, 2010

This review provides an overview of the current state of the art of magnetic resonance spectroscopy (MRS) in in vivo investigations of diffuse liver disease. So far, MRS of the human liver in vivo has mainly been used as a research tool rather than a clinical tool. The liver is particularly suitable for static and dynamic metabolic studies due to its high metabolic activity. Furthermore, its relatively superficial position allows excellent MRS localization, while its large volume allows detection of signals with relatively low intensity. This review describes the application of MRS to study the metabolic consequences of different conditions including diffuse and chronic liver diseases, congenital diseases, diabetes, and the presence of a distant malignancy on hepatic metabolism. In addition, future prospects of MRS are discussed. It is anticipated that future technical developments such as clinical MRS magnets with higher field strength (3 T) and improved delineation of multi-component signals such as phosphomonoester and phosphodiester using proton decoupling, especially if combined with price reductions for stable isotope tracers, will lead to intensified research into metabolic syndrome, cardiovascular disease, hepato-biliary diseases, as well as non-metastatic liver metabolism in patients with a distant malignant tumor.

Keywords: Cancer, Cirrhosis, Diabetes, Diffuse liver disease, Hepatitis, Magnetic resonance spectroscopy