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  • Non-invasive detection of 2...
    Pope, Whitney B.; Prins, Robert M.; Albert Thomas, M.; Nagarajan, Rajakumar; Yen, Katharine E.; Bittinger, Mark A.; Salamon, Noriko; Chou, Arthur P.; Yong, William H.; Soto, Horacio; Wilson, Neil; Driggers, Edward; Jang, Hyun G.; Su, Shinsan M.; Schenkein, David P.; Lai, Albert; Cloughesy, Timothy F.; Kornblum, Harley I.; Wu, Hong; Fantin, Valeria R.; Liau, Linda M.

    Journal of neuro-oncology, 03/2012, Letnik: 107, Številka: 1
    Journal Article

    Mutations of the isocitrate dehydrogenase 1 and 2 genes ( IDH1 and IDH2 ) are commonly found in primary brain cancers. We previously reported that a novel enzymatic activity of these mutations results in the production of the putative oncometabolite, R(−)-2-hydroxyglutarate (2-HG). Here we investigated the ability of magnetic resonance spectroscopy (MRS) to detect 2-HG production in order to non-invasively identify patients with IDH1 mutant brain tumors. Patients with intrinsic glial brain tumors ( n  = 27) underwent structural and spectroscopic magnetic resonance imaging prior to surgery. 2-HG levels from MRS data were quantified using LC-Model software, based upon a simulated spectrum obtained from a GAMMA library added to the existing prior knowledge database. The resected tumors were then analyzed for IDH1 mutational status by genomic DNA sequencing, Ki-67 proliferation index by immunohistochemistry, and concentrations of 2-HG and other metabolites by liquid chromatography–mass spectrometry (LC–MS). MRS detected elevated 2-HG levels in gliomas with IDH1 mutations compared to those with wild-type IDH1 ( P  = 0.003). The 2-HG levels measured in vivo with MRS were significantly correlated with those measured ex vivo from the corresponding tumor samples using LC–MS ( r 2  = 0.56; P  = 0.0001). Compared with wild-type tumors, those with IDH1 mutations had elevated choline ( P  = 0.01) and decreased glutathione ( P  = 0.03) on MRS. Among the IDH1 mutated gliomas, quantitative 2-HG values were correlated with the Ki-67 proliferation index of the tumors ( r 2  = 0.59; P  = 0.026). In conclusion, water-suppressed proton ( 1 H) MRS provides a non-invasive measure of 2-HG in gliomas, and may serve as a potential biomarker for patients with IDH1 mutant brain tumors. In addition to 2-HG, alterations in several other metabolites measured by MRS correlate with IDH1 mutation status.