Diagnostic performance of magnetic resonance spectroscopy in assessing metabolic profile for differentiating benign and malignant liver tumors: a review

Magnetic resonance spectroscopy is a noninvasive method that enables analysis of the metabolic profile of liver tissue and the identification of biochemical indicators of malignant transformation. In this review we summarize current research data on the use of magnetic resonance spectroscopy in the differential diagnosis of benign and malignant focal liver lesions and to assess the diagnostic value of metabolic indices. A search and selection of publications were performed in the PubMed, Web of Science, and Google Scholar databases using the following keywords: "magnetic resonance spectroscopy," "MRS," "liver lesion," "MRI," "choline/lipid," and "MRS metabolites." The analysis included articles published from inception of the said databases up to December 2024 that focused on the application of magnetic resonance spectroscopy for evaluating the metabolic profile of liver tumors. Numerous studies indicate that magnetic resonance spectroscopy allows for the detection of characteristic changes in the levels of choline, lipids, and other metabolites reflecting membrane and energy exchange processes. These parameters offer additional noninvasive criteria for differentiating benign and malignant liver lesions. Although routine clinical use of magnetic resonance spectroscopy remains limited, the method demonstrates high potential for the early detection of tumors and the assessment of their metabolic characteristics. Further research may contribute to the technique standardization and a deeper understanding of the biochemical mechanisms underlying tumor growth, which is particularly important in complex and diagnostically challenging cases.

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