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FIG 1. HMRS image (20 [TE], 2 x 2 x 2-cm voxel) obtained from healthy control subject shows the following normal metabolites: MI (Myo on image), Cho, Cr, and NAA. The small peak at 1.3–1.5 is probably due to lipid contamination (from subcutaneous tissues), which is expected when using this technique.FIG 2. HMRS image (20 [TE], 3 x 3 x 3-cm voxel) obtained from patient with histologically confirmed, recurrent, low-grade astrocytoma at posterior margin of prior resection shows high level of MI, mild elevation of Cho, mild decreased NAA, and elevation of lipids and lactate (Lip/Lac) as a sequela of therapy.FIG 3. HMRS image (20 [TE], 1.5 x 1.5 x 1.5-cm voxel) obtained from a patient with histologically confirmed, recurrent anaplastic astrocytoma at medial aspect of prior resection shows moderate levels of MI, elevated Cho, depressed NAA, and Lip/Lac, probably as a sequela of therapy.FIG 4. HMRS image (20 [TE], 2 x 2 x 2-cm voxel) obtained from a patient with GBM (histologically confirmed but not treated at time of this study) shows no MI, elevated Cho, depressed NAA, and very high levels of Lip/Lac, probably related to tumor necrosis
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