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Magnetic resonance spectroscopy (MRS) is one of the most powerful analytical techniques, being frequently used to derive physical, chemical, electronic, and structural information about molecules. Considering its potentialities and its evolution as cell/tissue response predictor, it can be used to detect changes in the tumor pathophysiology before, during, and after treatment. Of particular relevance to this analysis, due to its higher sensitivity, is proton magnetic resonance spectroscopy (1H-MRS) either applied directly in vivo or by using tumor biopsies and high-rotation magic angle spinning (HRMAS). Several metabolites have been quantified in several tumors, including creatine and phosphocreatine, choline, lactate and myoinositol, and used for distinguishing different cancer types. Several advantages characterize this technique including swiftness and ability to support the characterization of tumoral lesions on the basis of their biochemical composition, which may provide additional diagnostic and prognostic information as an adjunct to routine histological assessment. Many tumors have already been studied by 1H-MRS, and there is growing interest in studying others in order to establish extended metabolite databases which could help in their identification and characterization.
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