A quantitative total water content and relaxation method (TWC) was compared to the commonly used segmentation based approach (SEG) to calculate absolute metabolite concentrations in magnetic resonance spectroscopy. Significantly different water concentrations and attenuation factors were found between TWC and SEG in both grey and white matter from scans of 6 healthy controls at 3T. These differences led to significantly different concentrations of total creatine and myo-inositol in white matter, and N-acetyl-aspartate, total creatine, and glutamate in grey matter. The TWC approach is a promising alternative to improve MRS concentration estimates across healthy and diseased cohorts, and different MRI scanners.
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