Journal
JOURNAL OF MAGNETIC RESONANCE IMAGING
Volume 44, Issue 4, Pages 823-833Publisher
WILEY
DOI: 10.1002/jmri.25221
Keywords
human brain tumors; isocitrate dehydrogenase; magnetic resonance spectroscopy; neurooncology; neuroradiology
Funding
- Medical Faculty of Eberhard Karls University Tubingen [F1358006.1]
- German Research Foundation [DFG SCHE 658/2]
- Max Planck Society
- Ministry of Science, Research and the Arts of Baden-Wuerttemberg [Az: 32-771-8-1504.12/1/1]
- MRC [MR/M009106/1] Funding Source: UKRI
- Medical Research Council [MR/M009106/1] Funding Source: researchfish
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PurposeTo examine in vivo metabolic alterations in the isocitrate dehydrogenase (IDH) mutated gliomas using magnetic resonance spectroscopy (MRS) at magnetic field 9.4T. Materials and MethodsSpectra were acquired with a 9.4T whole-body scanner with the use of a custom-built head coil (16 channel transmit and 31 channel receive). A modified stimulated echo acquisition mode (STEAM) sequence was used for localization. Eighteen patients with brain tumors of probable glial origin participated in this study. The study was performed in accordance with the guidelines of the local Ethics Committee. ResultsThe increased spectral resolution allowed us to directly address metabolic alterations caused by the specific pathophysiology of IDH mutations including the presence of the oncometabolite 2-hydroxglutarate (2HG) and a significant decrease of the pooled glutamate and glutamine (20%, P=0.024), which probably reflects an attempt to replenish -ketoglutarate lost by conversion to 2HG. We also observed significantly reduced glutathione (GSH) levels (39%, P=0.019), which could be similarly caused by depletion of dihydronicotinamide-adenine dinucleotide phosphate (NADPH) during this conversion in IDH mutant gliomas. ConclusionWe demonstrate that MRS at 9.4T provides a noninvasive measure of 2HG in vivo, which may be used for therapy planning and prognostication, and may provide insights into related pathophysiologic metabolic alterations associated with IDH mutations. J. MAGN. RESON. IMAGING 2016;44:823-833.
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