Abstract:
BACKGROUND:The majority of WHO grades II and III gliomas harbor a missense mutation in the metabolic gene isocitrate dehydrogenase (IDH) and accumulate the metabolite R-2-hydroxyglutarate (R-2HG). Prior studies showed that this metabolite can be detected in vivo using proton magnetic-resonance spectroscopy (MRS), but the sensitivity of this methodology and its clinical implications are unknown. METHODS:We developed an MR imaging protocol to integrate 2HG-MRS into routine clinical glioma imaging and examined its performance in 89 consecutive glioma patients. RESULTS:Detection of 2-hydroxyglutarate (2HG) in IDH-mutant gliomas was closely linked to tumor volume, with sensitivity ranging from 8% for small tumors (<3.4 mL) to 91% for larger tumors (>8 mL). In patients undergoing 2HG-MRS prior to surgery, tumor levels of 2HG corresponded with tumor cellularity but not with tumor grade or mitotic index. Cytoreductive therapy resulted in a gradual decrease in 2HG levels with kinetics that closely mirrored changes in tumor volume. CONCLUSIONS:Our study demonstrates that 2HG-MRS can be linked with routine MR imaging to provide quantitative measurements of 2HG in glioma and may be useful as an imaging biomarker to monitor the abundance of IDH-mutant tumor cells noninvasively during glioma therapy and disease monitoring.
journal_name
Neuro Oncoljournal_title
Neuro-oncologyauthors
de la Fuente MI,Young RJ,Rubel J,Rosenblum M,Tisnado J,Briggs S,Arevalo-Perez J,Cross JR,Campos C,Straley K,Zhu D,Dong C,Thomas A,Omuro AA,Nolan CP,Pentsova E,Kaley TJ,Oh JH,Noeske R,Maher E,Choi C,Gutin PH,Hodoi
10.1093/neuonc/nov307subject
Has Abstractpub_date
2016-02-01 00:00:00pages
283-90issue
2eissn
1522-8517issn
1523-5866pii
nov307journal_volume
18pub_type
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