Diffusion-weighted MR spectroscopy: consensus, recommendations and resources from acquisition to modelling

Brain cell structure and function reflect neurodevelopment, plasticity and ageing, and changes can help flag pathological processes such as neurodegeneration and neuroinflammation. Accurate and quantitative methods to non-invasively disentangle cellular structural features are needed and are a substantial focus of brain research. Diffusion-weighted MR spectroscopy (dMRS) gives access to diffusion properties of endogenous intracellular brain metabolites that are preferentially located inside specific brain cell populations. Despite its great potential, dMRS remains a challenging technique on all levels: from the data acquisition to the analysis, quantification, modelling and interpretation of results. These challenges were the motivation behind the organisation of the Lorentz Workshop on 'Best Practices and Tools for Diffusion MR Spectroscopy' held in Leiden in September 2021. During the workshop, the dMRS community established a set of recommendations to execute robust dMRS studies. This paper provides a description of the steps needed for acquiring, processing, fitting and modelling dMRS data and provides links to useful resources.