Comparison of 31P saturation and inversion magnetization transfer in human liver and skeletal muscle using a clinical MR system and surface coils

³¹P MRS magnetization transfer (³¹P‐MT) experiments allow the estimation of exchange rates of biochemical reactions, such as the creatine kinase equilibrium and adenosine triphosphate (ATP) synthesis. Although various ³¹P‐MT methods have been successfully used on isolated organs or animals, their application on humans in clinical scanners poses specific challenges. This study compared two major ³¹P‐MT methods on a clinical MR system using heteronuclear surface coils. Although saturation transfer (ST) is the most commonly used ³¹P‐MT method, sequences such as inversion transfer (IT) with short pulses might be better suited for the specific hardware and software limitations of a clinical scanner. In addition, small NMR‐undetectable metabolite pools can transfer MT to NMR‐visible pools during long saturation pulses, which is prevented with short pulses. ³¹P‐MT sequences were adapted for limited pulse length, for heteronuclear transmit–receive surface coils with inhomogeneous B₁, for the need for volume selection and for the inherently low signal‐to‐noise ratio (SNR) on a clinical 3‐T MR system. The ST and IT sequences were applied to skeletal muscle and liver in 10 healthy volunteers. Monte‐Carlo simulations were used to evaluate the behavior of the IT measurements with increasing imperfections. In skeletal muscle of the thigh, ATP synthesis resulted in forward reaction constants (k) of 0.074 ±0.022 s^–1 (ST) and 0.137 ±0.042 s^–1 (IT), whereas the creatine kinase reaction yielded 0.459 ±0.089 s^–1 (IT). In the liver, ATP synthesis resulted in k = 0.267 ±0.106 s^–1 (ST), whereas the IT experiment yielded no consistent results. ST results were close to literature values; however, the IT results were either much larger than the corresponding ST values and/or were widely scattered. To summarize, ST and IT experiments can both be implemented on a clinical body scanner with heteronuclear transmit–receive surface coils; however, ST results are much more robust against experimental imperfections than the current implementation of IT. Copyright © 2014 John Wiley & Sons, Ltd.