Article
IDH mutation prediction in glioma using 2-Hydroxyglutarate magnetic resonance spectroscopy
Prädiktion des IDH-Mutationsstatus in Gliomen mittels 2-Hydroxyglutarat Magnetresonanzspektorskopie
Search Medline for
Authors
Published: | May 25, 2022 |
---|
Outline
Text
Objective: Non-invasive and accurate diagnostic techniques to detect isocitrate dehydrogenase (IDH) mutant glioma have great potential in routine clinical practice. To date, only a few centers worldwide were able to establish 2HG detection by magnetic resonance spectroscopy (MRS) in glioma. Here, we report on the results of 2-Hydroxyglutarate (2HG) single-voxel spectroscopy (SVS) in a large glioma patient’s cohort.
Methods: A total of 74 glioma patients were prospectively investigated using point-resolved spectroscopy at 3 T in parallel with standard clinical magnetic resonance imaging and assessment. The IDH1/2 mutation status was determined using next generation sequencing in the glioma tissue. In addition, in a subset of patients (n=9), 2HG concentrations were measured in the tissue by liquid chromatography-tandem mass spectrometry (LCMS).
Results: Only cases with histologic confirmation were included in the analysis (n=52). The cohort persisted of 38 IDH mutant gliomas (19 astrocytomas, 13 oligodendrogliomas and 6 glioblastomas), 8 IDH wild-type glioblastomas, three radiation-associated necrosis and three other benign pathologies. The 2HG concentration in the spectroscopy varied between 0.45 and 6.9 mM. IDH mutations were correctly predicted by 2HG-MRS with 82.1% sensitivity and 63.6% specificity. Analyzing the 2HG level with LCMS in false positive (n= 5) and false negative (n=4) cases confirmed the false predication of 2HG-MRS. Importantly, all three cases with a radiation-associated necrosis in IDH mutant gliomas were predicted correctly.
Conclusion: Our findings suggest that 2HG spectroscopy is a reliable and reproducible method in IDH mutation prediction in gliomas, from indolent disease through post-treatment follow-up. We envision that 2HG MRS can be used as a diagnostic tool in glioma clinical trials.