Integration of 2-hydroxyglutarate-proton magnetic resonance spectroscopy into clinical practice for disease monitoring in isocitrate dehydrogenase-mutant glioma Journal Article
| Authors: | de la Fuente, M. I.; Young, R. J.; Rubel, J.; Rosenblum, M.; Tisnado, J.; Briggs, S.; Arevalo-Perez, J.; Cross, J. R.; Campos, C.; Straley, K.; Zhu, D.; Dong, C.; Thomas, A.; Omuro, A. A.; Nolan, C. P.; Pentsova, E.; Kaley, T. J.; Oh, J. H.; Noeske, R.; Maher, E.; Choi, C.; Gutin, P. H.; Holodny, A. I.; Yen, K.; DeAngelis, L. M.; Mellinghoff, I. K.; Thakur, S. B. |
| Article Title: | Integration of 2-hydroxyglutarate-proton magnetic resonance spectroscopy into clinical practice for disease monitoring in isocitrate dehydrogenase-mutant glioma |
| 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. © 2015 The Author(s). |
| Keywords: | glioma; magnetic resonance spectroscopy; idh; imaging biomarker; cancer metabolism; r-2-hydroxyglutarate |
| Journal Title: | Neuro-Oncology |
| Volume: | 18 |
| Issue: | 2 |
| ISSN: | 1522-8517 |
| Publisher: | Oxford University Press |
| Date Published: | 2016-02-01 |
| Start Page: | 283 |
| End Page: | 290 |
| Language: | English |
| DOI: | 10.1093/neuonc/nov307 |
| PROVIDER: | scopus |
| PMCID: | PMC4724186 |
| PUBMED: | 26691210 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 4 April 2016 -- Source: Scopus |
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