Evaluating tissue bioenergetics by phosphorous-31 magnetic resonance spectroscopy

Abstract Phosphorous-31 (31P) magnetic resonance spectroscopy (MRS) provides the opportunity for noninvasively interrogating energy metabolism in living organisms. 31P-MRS applications in preclinical research have greatly enhanced our understanding of metabolic regulation under normal and various diseased conditions. With the increasing recognition of the importance of metabolism in a wide range of prevalent diseases, 31P-MRS has also stimulated considerable interest in clinical applications in recent years. Thanks to the remarkable progress in MRS technology in the past two decades and the increasing availability of high-field scanners in hospital settings, 31P-MRS is becoming available as a routine clinical research tool. It has the potential to enable sensitive detection of metabolic dysfunction at an early stage of disease development. This chapter provides an overview of the physical principles of MRS and the applications of 31P-MRS in assessing various aspects of tissue energetics.