In vivo MR spectroscopy is often characterised by a spectral signal-to-noise ratio (SNR) that varies highly between experiments, particularly when investigating non-proton nuclei. A common design for spectroscopic studies is to compare the ratio of two spectral peak amplitudes between groups, e.g. individual PCr/$$$\gamma$$$-ATP ratios in phosphorus MRS, or bicarbonate-to-pyruvate ratios in hyperpolarized $$$^{13}$$$C MRS. The uncertainty on this ratio is often neglected. We show that the correct propagation of this uncertainty improves statistical power.
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