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- Title
In vivo 2-hydroxyglutarate-proton magnetic resonance spectroscopy (3 T, PRESS technique) in treatment-naïve suspect lower-grade gliomas: feasibility and accuracy in a clinical setting.
- Authors
Cuccarini, Valeria; Antelmi, Luigi; Pollo, Bianca; Paterra, Rosina; Calatozzolo, Chiara; Nigri, Anna; DiMeco, Francesco; Eoli, Marica; Finocchiaro, Gaetano; Brenna, Greta; Tramacere, Irene; Bruzzone, Maria Grazia; Anghileri, Elena
- Abstract
Isocitrate dehydrogenase 1/2 (IDH1/2) mutations are often detected in lower-grade gliomas (LGG) and result into 2-hydroxyglutarate (2HG) synthesis. Prior studies showed that 2HG can be detected in vivo using magnetic resonance spectroscopy (MRS), but its accuracy and translational impact are still under investigation.<bold>Purpose: </bold>To investigate the clinical feasibility of MRS for in vivo detection and quantification of 2HG on consecutive treatment-naïve suspect LGG patients and to compare MRS accuracy with tissue IDH1/2 analysis.<bold>Methods: </bold>MRS spectra at 3 T were acquired with 1H-MRS single-voxel PRESS 2HG-tailored sequences with TE 30 (group 1) or TE 97 (groups 2A and B). Voxel sizes were 1.5 × 1.5 × 1.5 cm3 for group 1 (n = 13) and group 2A (n = 14) and 2 × 2 × 2 cm3 for group 2B (n = 32). Multiple metabolites' concentrations were analyzed with LCModel. Tumors were assessed for IDH status and main molecular markers. 2HG levels in urine/blood were measured by liquid chromatography-mass spectrometry.<bold>Results: </bold>The larger voxel TE 97 sequence resulted in highest specificity (100%), sensitivity (79%), and accuracy (87%). Urine and blood 2HG did not result predictive.<bold>Conclusion: </bold>Our data confirm that 2 × 2 × 2-cm3 voxel TE 97 MRS shows high accuracy for 2HG detection, with good sensitivity and 100% specificity in distinguishing IDH mutant gliomas. Main limits of the technique are small tumor volume and low cellularity. Integrating 2HG-MRS with other metabolites may help non-invasive diagnosis of glioma, prognostic assessment, and treatment planning in clinical setting.
- Subjects
NUCLEAR magnetic resonance spectroscopy; GLIOMAS; LIQUID chromatography-mass spectrometry; ISOCITRATE dehydrogenase; OLIGODENDROGLIOMAS; TISSUE analysis; PILOT projects; PROTON magnetic resonance spectroscopy; PROGNOSIS; ACYCLIC acids; OXIDOREDUCTASES
- Publication
Neurological Sciences, 2020, Vol 41, Issue 2, p347
- ISSN
1590-1874
- Publication type
journal article
- DOI
10.1007/s10072-019-04087-9