The Correlation of In Vivo MR Spectroscopy and Ex Vivo 2-Hydroxyglutarate Concentration for the Prediction of Isocitrate Dehydrogenase Mutation Status in Diffuse Glioma
Bart R. J. van Dijken,
Hanne-Rinck Jeltema,
Justyna Kłos,
Peter Jan van Laar,
Roelien H. Enting,
Ronald G. H. J. Maatman,
Klaas Bijsterveld,
Wilfred F. A. Den Dunnen,
Rudi A. Dierckx,
Paul E. Sijens,
Anouk van der Hoorn
Affiliations
Bart R. J. van Dijken
Department of Radiology, Medical Imaging Center (MIC), University Medical Center Groningen (UMCG), 9700 RB Groningen, The Netherlands
Hanne-Rinck Jeltema
Department of Neurosurgery, University Medical Center Groningen (UMCG), 9700 RB Groningen, The Netherlands
Justyna Kłos
Department of Radiology, Medical Imaging Center (MIC), University Medical Center Groningen (UMCG), 9700 RB Groningen, The Netherlands
Peter Jan van Laar
Department of Radiology, Hospital Group Twente (ZGT), 7600 SZ Almelo, The Netherlands
Roelien H. Enting
Department of Neurology, University Medical Center Groningen (UMCG), 9700 RB Groningen, The Netherlands
Ronald G. H. J. Maatman
Department of Laboratory Medicine, University Medical Center Groningen (UMCG), 9700 RB Groningen, The Netherlands
Klaas Bijsterveld
Department of Laboratory Medicine, University Medical Center Groningen (UMCG), 9700 RB Groningen, The Netherlands
Wilfred F. A. Den Dunnen
Department of Pathology, University Medical Center Groningen (UMCG), 9700 RB Groningen, The Netherlands
Rudi A. Dierckx
Department of Radiology, Medical Imaging Center (MIC), University Medical Center Groningen (UMCG), 9700 RB Groningen, The Netherlands
Paul E. Sijens
Department of Radiology, Medical Imaging Center (MIC), University Medical Center Groningen (UMCG), 9700 RB Groningen, The Netherlands
Anouk van der Hoorn
Department of Radiology, Medical Imaging Center (MIC), University Medical Center Groningen (UMCG), 9700 RB Groningen, The Netherlands
Isocitrate dehydrogenase (IDH) mutation status is an important biomarker in the glioma-defining subtype and corresponding prognosis. This study proposes a straightforward method for 2-hydroxyglutarate (2-HG) quantification by MR spectroscopy for IDH mutation status detection and directly compares in vivo 2-HG MR spectroscopy with ex vivo 2-HG concentration measured in resected tumor tissue. Eleven patients with suspected lower-grade glioma (ten IDH1; one IDHwt) were prospectively included. Preoperatively, 3T point-resolved spectroscopy (PRESS) was acquired; 2-HG was measured as the percentage elevation of Glx3 (the sum of 2-HG and Glx) compared to Glx4. IDH mutation status was assessed by immunochemistry or direct sequencing. The ex vivo 2-HG concentration was determined in surgically obtained tissue specimens using gas chromatography–mass spectrometry. Pearson correlation was used for assessing the correlation between in vivo MR spectroscopy and ex vivo 2-HG concentration. MR spectroscopy was positive for 2-HG in eight patients, all of whom had IDH1 tumors. A strong correlation (r = 0.80, p = 0.003) between 2-HG MR spectroscopy and the ex vivo 2-HG concentration was found. This study shows in vivo 2-HG MR spectroscopy can non-invasively determine IDH status in glioma and demonstrates a strong correlation with ex vivo 2-HG concentration in patients with lower-grade glioma.
