Noninvasive assessment of isocitrate dehydrogenase mutation status in cerebral gliomas by magnetic resonance spectroscopy in a clinical setting.

Abstract:

:OBJECTIVE Mutations in the isocitrate dehydrogenase (IDH) genes are of proven diagnostic and prognostic significance for cerebral gliomas. The objective of this study was to evaluate the clinical feasibility of using a recently described method for determining IDH mutation status by using magnetic resonance spectroscopy (MRS) to detect the presence of 2-hydroxyglutarate (2HG), the metabolic product of the mutant IDH enzyme. METHODS By extending imaging time by 6 minutes, the authors were able to include a point-resolved spectroscopy (PRESS) MRS sequence in their routine glioma imaging protocol. In 30 of 35 patients for whom this revised protocol was used the lesions were subsequently diagnosed histologically as gliomas. Of the remaining 5 patients, 1 had a gangliocytoma, 1 had a primary CNS lymphoma, and 3 had nonneoplastic lesions. Immunohistochemistry and/or polymerase chain reaction were used to detect the presence of IDH mutations in the glioma tissue resected. RESULTS In vivo MRS for 2HG correctly identified the IDH mutational status in 88.6% of patients. The sensitivity and specificity was 89.5% and 81.3%, respectively, when using 2 mM 2HG as threshold to discriminate IDH-mutated from wildtype tumors. Two glioblastomas that had elevated 2HG levels did not have detectable IDH mutations, and in 2 IDH-mutated gliomas 2HG was not reliably detectable. CONCLUSIONS The noninvasive determination of the IDH mutation status of a presumed glioma by means of MRS may be incorporated into a routine diagnostic imaging protocol and can be used to obtain additional information for patient care.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Tietze A,Choi C,Mickey B,Maher EA,Parm Ulhøi B,Sangill R,Lassen-Ramshad Y,Lukacova S,Østergaard L,von Oettingen G

doi

10.3171/2016.10.JNS161793

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

391-398

issue

2

eissn

0022-3085

issn

1933-0693

pii

2016.10.JNS161793

journal_volume

128

pub_type

杂志文章
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    authors: Marubayashi T,Matsukado Y

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  • Multiple burr-hole operation for adult moyamoya disease.

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    pub_type: 历史文章,杂志文章

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    pub_type: 杂志文章

    doi:10.3171/jns.1986.65.1.0122

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    pub_type: 杂志文章

    doi:10.3171/jns.1996.84.1.0127

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    pub_type: 杂志文章

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    pub_type: 杂志文章

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    pub_type: 杂志文章

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    pub_type: 杂志文章,随机对照试验

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