Journal
NMR IN BIOMEDICINE
Volume 31, Issue 3, Pages -Publisher
WILEY
DOI: 10.1002/nbm.3886
Keywords
2-HG; detection; glioma; ultra-high field
Funding
- National Institute for Health Research (NIHR) Oxford Biomedical Research Centre
- Dunhill Medical Trust
- Welcome Trust
- Engineering and Physical Sciences Research Council (ESPRC)
- Cancer Research UK [16466] Funding Source: researchfish
- Medical Research Council [G0900806] Funding Source: researchfish
- MRC [G0900806] Funding Source: UKRI
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Abnormally high levels of the oncometabolite' 2-hydroxyglutarate (2-HG) occur in many grade II and III gliomas, and correlate with mutations in the genes of isocitrate dehydrogenase (IDH) isoforms. In vivo measurement of 2-HG in patients, using magnetic resonance spectroscopy (MRS), has largely been carried out at 3T, yet signal overlap continues to pose a challenge for 2-HG detection. To combat this, several groups have proposed MRS methods at ultra-high field (=7T) where theoretical increases in signal-to-noise ratio and spectral resolution could improve 2-HG detection. Long echo time (long-TE) semi-localization by adiabatic selective refocusing (semi-LASER) (TE = 110ms) is a promising method for improved 2-HG detection in vivo at either 3 or 7T owing to the use of broad-band adiabatic localization. Using previously published semi-LASER methods at 3 and 7T, this study directly compares the detectability of 2-HG in phantoms and in vivo across nine patients. Cramer-Rao lower bounds (CRLBs) of 2-HG fitting were found to be significantly lower at 7T (6 +/- 2%) relative to 3T (15 +/- 7%) (p = 0.0019), yet were larger at 7T in an IDH wild-type patient. Although no increase in SNR was detected at 7T (77 +/- 26) relative to 3T (77 +/- 30), the detection of 2-HG was greatly enhanced through an improved spectral profile and increased resolution at 7T. 7T had a large effect on pairwise fitting correlations between -aminobutyric acid (GABA) and 2-HG (p = 0.004), and resulted in smaller coefficients. The increased sensitivity for 2-HG detection using long-TE acquisition at 7T may allow for more rapid estimation of 2-HG (within a few spectral averages) together with other associated metabolic markers in glioma.
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