Several practical obstacles in data handling and evaluation complicate the use of quantitative localized magnetic resonance spectroscopy (qMRS) in clinical routine MR examinations. To overcome these obstacles, a clinically feasible MR pulse sequence protocol based on standard available MR pulse sequences for qMRS has been implemented along with newly added functionalities to the free software package jMRUI-v5.0 to make qMRS attractive for clinical routine. This enables (a) easy and fast DICOM data transfer from the MR console and the qMRS-computer, (b) visualization of combined MR spectroscopy and imaging, (c) creation and network transfer of spectroscopy reports in DICOM format, (d) integration of advanced water reference models for absolute quantification, and (e) setup of databases containing normal metabolite concentrations of healthy subjects. To demonstrate the work-flow of qMRS using these implementations, databases for normal metabolite concentration in different regions of brain tissue were created using spectroscopic data acquired in 55 normal subjects (age range 6-61 years) using 1.5T and 3T MR systems, and illustrated in one clinical case of typical brain tumor (primitive neuroectodermal tumor). The MR pulse sequence protocol and newly implemented software functionalities facilitate the incorporation of qMRS and reference to normal value metabolite concentration data in daily clinical routine. Techniques for quantitative localized in vivo magnetic resonance spectroscopy (qMRS) have been available for 30 years and were used in countless research projects (1-4). The potential value of qMRS in a clinical setting has especially been demonstrated in the characterization of pathologic tissue changes, where the diagnosis is not evident in MR imaging and in tissues that are not readily available to biopsy (e.g., intracerebral tumors) (5). Despite the fact that localized in vivo MR spectroscopy is noninvasive, and produces quantitative biochemical information (6), its use in clinical routine examinations is still very limited. There are several reasons for this:First, as MR images are closely linked to anatomical structures, their interpretation is for clinical radiologists much more intuitive than that of MR spectra. To interpret MR spectra correctly, knowledge about the signal acquisition and signal artifacts is mandatory. To obtain this knowledge, training is required with experienced spectroscopists, which is not possible in most clinical centers. Furthermore, background knowledge about cellular metabolism is also necessary in order to meaningfully interpret the limited number of metabolites in MR spectra. Compared to the immense amount of different structural proteins, enzymes, and metabolites of a human cell, the very few substances that can be measured using MR spectroscopy yield a low specificity and sensitivity in the context of pathologic tissue changes.Second, clinical MR scanners and manufacturer's spectroscopy postprocessing software have greatly improved and became user-friendly in the recent ye...