Magnetic resonance spectroscopic assessment of isocitrate dehydrogenase status in gliomas: the new frontiers of spectrobiopsy in neurodiagnostics

Antonio Di Ieva, John S. Magnussen, Jeffery McIntosh, Michael J. Mulcahy, Margery Pardey, Changho Choi

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: In the era of integrated genomic-histologic analysis of brain tumors, new biomarkers have been introduced as diagnostic, prognostic, and therapeutic indicators. The analysis of the mutation in the isocitrate dehydrogenase (IDH) genes IDH1 and IDH2 has provided important diagnostic and prognostic information for patients affected by diffuse glioma (i.e., the presence of the mutation has been related to an increased survival rate). The reference standard of IDH mutation detection has been its assessment in surgical specimens, immunohistochemistry, and/or genetic sequencing. Knowing the IDH status information preoperatively would be of great importance, because it has been related to tumor progression and the response to treatment. The oncometabolite 2-hydroxyglutarate (2HG), accumulated in gliomas with IDH mutation status, can be detected in vivo using magnetic resonance spectroscopy (MRS). Methods: The 2HG-MRS technique remains technically challenging. We have summarized the results of the first pilot study in Australia, which included 10 patients affected by glioma. The data recorded from May 2017 to November 2018 were analyzed. Results: In our exploratory study, we reached a sensitivity and specificity of 100%, confirming the strong predictive role of 2HG, as detected using MRS, in the diagnosis of glioma. Conclusion: In the present study, we have focused on methodological tips and future perspectives of the technique in the neuroimaging and neuro-oncological scenario. We would advocate the integration of 2HG-MRS into standard clinical practice.

LanguageEnglish
Pagese421-e427
Number of pages7
JournalWorld Neurosurgery
Volume133
DOIs
Publication statusPublished - Jan 2020

Fingerprint

Isocitrate Dehydrogenase
Glioma
Magnetic Resonance Spectroscopy
Mutation
Tumor Biomarkers
Neuroimaging
Brain Neoplasms
Survival Rate
Immunohistochemistry
Sensitivity and Specificity
alpha-hydroxyglutarate
Therapeutics
Genes
Neoplasms

Keywords

  • 2-Hydroxyglutarate
  • 2HG
  • Glioma
  • Magnetic resonance spectroscopy
  • MRS
  • Neuroimaging

Cite this

@article{9c64a2d9cda84aecba789df6e2a84849,
title = "Magnetic resonance spectroscopic assessment of isocitrate dehydrogenase status in gliomas: the new frontiers of spectrobiopsy in neurodiagnostics",
abstract = "Background: In the era of integrated genomic-histologic analysis of brain tumors, new biomarkers have been introduced as diagnostic, prognostic, and therapeutic indicators. The analysis of the mutation in the isocitrate dehydrogenase (IDH) genes IDH1 and IDH2 has provided important diagnostic and prognostic information for patients affected by diffuse glioma (i.e., the presence of the mutation has been related to an increased survival rate). The reference standard of IDH mutation detection has been its assessment in surgical specimens, immunohistochemistry, and/or genetic sequencing. Knowing the IDH status information preoperatively would be of great importance, because it has been related to tumor progression and the response to treatment. The oncometabolite 2-hydroxyglutarate (2HG), accumulated in gliomas with IDH mutation status, can be detected in vivo using magnetic resonance spectroscopy (MRS). Methods: The 2HG-MRS technique remains technically challenging. We have summarized the results of the first pilot study in Australia, which included 10 patients affected by glioma. The data recorded from May 2017 to November 2018 were analyzed. Results: In our exploratory study, we reached a sensitivity and specificity of 100{\%}, confirming the strong predictive role of 2HG, as detected using MRS, in the diagnosis of glioma. Conclusion: In the present study, we have focused on methodological tips and future perspectives of the technique in the neuroimaging and neuro-oncological scenario. We would advocate the integration of 2HG-MRS into standard clinical practice.",
keywords = "2-Hydroxyglutarate, 2HG, Glioma, Magnetic resonance spectroscopy, MRS, Neuroimaging",
author = "{Di Ieva}, Antonio and Magnussen, {John S.} and Jeffery McIntosh and Mulcahy, {Michael J.} and Margery Pardey and Changho Choi",
year = "2020",
month = "1",
doi = "10.1016/j.wneu.2019.09.040",
language = "English",
volume = "133",
pages = "e421--e427",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier",

}

Magnetic resonance spectroscopic assessment of isocitrate dehydrogenase status in gliomas : the new frontiers of spectrobiopsy in neurodiagnostics. / Di Ieva, Antonio; Magnussen, John S.; McIntosh, Jeffery; Mulcahy, Michael J.; Pardey, Margery; Choi, Changho.

In: World Neurosurgery, Vol. 133, 01.2020, p. e421-e427.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Magnetic resonance spectroscopic assessment of isocitrate dehydrogenase status in gliomas

T2 - World Neurosurgery

AU - Di Ieva, Antonio

AU - Magnussen, John S.

AU - McIntosh, Jeffery

AU - Mulcahy, Michael J.

AU - Pardey, Margery

AU - Choi, Changho

PY - 2020/1

Y1 - 2020/1

N2 - Background: In the era of integrated genomic-histologic analysis of brain tumors, new biomarkers have been introduced as diagnostic, prognostic, and therapeutic indicators. The analysis of the mutation in the isocitrate dehydrogenase (IDH) genes IDH1 and IDH2 has provided important diagnostic and prognostic information for patients affected by diffuse glioma (i.e., the presence of the mutation has been related to an increased survival rate). The reference standard of IDH mutation detection has been its assessment in surgical specimens, immunohistochemistry, and/or genetic sequencing. Knowing the IDH status information preoperatively would be of great importance, because it has been related to tumor progression and the response to treatment. The oncometabolite 2-hydroxyglutarate (2HG), accumulated in gliomas with IDH mutation status, can be detected in vivo using magnetic resonance spectroscopy (MRS). Methods: The 2HG-MRS technique remains technically challenging. We have summarized the results of the first pilot study in Australia, which included 10 patients affected by glioma. The data recorded from May 2017 to November 2018 were analyzed. Results: In our exploratory study, we reached a sensitivity and specificity of 100%, confirming the strong predictive role of 2HG, as detected using MRS, in the diagnosis of glioma. Conclusion: In the present study, we have focused on methodological tips and future perspectives of the technique in the neuroimaging and neuro-oncological scenario. We would advocate the integration of 2HG-MRS into standard clinical practice.

AB - Background: In the era of integrated genomic-histologic analysis of brain tumors, new biomarkers have been introduced as diagnostic, prognostic, and therapeutic indicators. The analysis of the mutation in the isocitrate dehydrogenase (IDH) genes IDH1 and IDH2 has provided important diagnostic and prognostic information for patients affected by diffuse glioma (i.e., the presence of the mutation has been related to an increased survival rate). The reference standard of IDH mutation detection has been its assessment in surgical specimens, immunohistochemistry, and/or genetic sequencing. Knowing the IDH status information preoperatively would be of great importance, because it has been related to tumor progression and the response to treatment. The oncometabolite 2-hydroxyglutarate (2HG), accumulated in gliomas with IDH mutation status, can be detected in vivo using magnetic resonance spectroscopy (MRS). Methods: The 2HG-MRS technique remains technically challenging. We have summarized the results of the first pilot study in Australia, which included 10 patients affected by glioma. The data recorded from May 2017 to November 2018 were analyzed. Results: In our exploratory study, we reached a sensitivity and specificity of 100%, confirming the strong predictive role of 2HG, as detected using MRS, in the diagnosis of glioma. Conclusion: In the present study, we have focused on methodological tips and future perspectives of the technique in the neuroimaging and neuro-oncological scenario. We would advocate the integration of 2HG-MRS into standard clinical practice.

KW - 2-Hydroxyglutarate

KW - 2HG

KW - Glioma

KW - Magnetic resonance spectroscopy

KW - MRS

KW - Neuroimaging

UR - http://www.scopus.com/inward/record.url?scp=85073546685&partnerID=8YFLogxK

U2 - 10.1016/j.wneu.2019.09.040

DO - 10.1016/j.wneu.2019.09.040

M3 - Article

VL - 133

SP - e421-e427

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -