Incorporation of Edited MRS into Clinical Practice May Improve Care of Patients with IDH -Mutant Glioma.

Autor:	Nichelli L; From the Department of Neuroradiology (L.N., P.L., S.L.), La Pitié Salpêtrière University Hospital, Assistance publique-hôpitaux de Paris, Paris, France lucia.nichelli@aphp.fr.; The Paris Brain Institute (L.N., C.C., B.M., M.T., M.S., F. Bielle, S.L., F. Branzoli), Sorbonne University, Institut national de la santé et de la Recherche Médicale 1127, Centre National de la Recherche Scientifique, Joint Research Unit 7225, Equipe Labellisée Ligue Nationale Contre le Cancer, Paris, France., Cadin C; The Paris Brain Institute (L.N., C.C., B.M., M.T., M.S., F. Bielle, S.L., F. Branzoli), Sorbonne University, Institut national de la santé et de la Recherche Médicale 1127, Centre National de la Recherche Scientifique, Joint Research Unit 7225, Equipe Labellisée Ligue Nationale Contre le Cancer, Paris, France., Lazzari P; From the Department of Neuroradiology (L.N., P.L., S.L.), La Pitié Salpêtrière University Hospital, Assistance publique-hôpitaux de Paris, Paris, France.; Department of Radiology (P.L.), University of Modena and Reggio Emilia, AOU Policlinico di Modena, Modena, Italy., Mathon B; Department of Neurosurgery (B.M.), La Pitié Salpêtrière University Hospital, Paris, France.; The Paris Brain Institute (L.N., C.C., B.M., M.T., M.S., F. Bielle, S.L., F. Branzoli), Sorbonne University, Institut national de la santé et de la Recherche Médicale 1127, Centre National de la Recherche Scientifique, Joint Research Unit 7225, Equipe Labellisée Ligue Nationale Contre le Cancer, Paris, France., Touat M; Department of Neuro-oncology (M.T., M.S.), La Pitié Salpêtrière University Hospital, Paris, France.; The Paris Brain Institute (L.N., C.C., B.M., M.T., M.S., F. Bielle, S.L., F. Branzoli), Sorbonne University, Institut national de la santé et de la Recherche Médicale 1127, Centre National de la Recherche Scientifique, Joint Research Unit 7225, Equipe Labellisée Ligue Nationale Contre le Cancer, Paris, France., Sanson M; Department of Neuro-oncology (M.T., M.S.), La Pitié Salpêtrière University Hospital, Paris, France.; The Paris Brain Institute (L.N., C.C., B.M., M.T., M.S., F. Bielle, S.L., F. Branzoli), Sorbonne University, Institut national de la santé et de la Recherche Médicale 1127, Centre National de la Recherche Scientifique, Joint Research Unit 7225, Equipe Labellisée Ligue Nationale Contre le Cancer, Paris, France., Bielle F; The Paris Brain Institute (L.N., C.C., B.M., M.T., M.S., F. Bielle, S.L., F. Branzoli), Sorbonne University, Institut national de la santé et de la Recherche Médicale 1127, Centre National de la Recherche Scientifique, Joint Research Unit 7225, Equipe Labellisée Ligue Nationale Contre le Cancer, Paris, France.; Department of Neuropathology (F. Bielle), La Pitié Salpêtrière University Hospital, Paris, France., Marjańska M; Center for Magnetic Resonance Research (M.M.), Department of Radiology, University of innesota, Minneapolis, Minnesota., Lehéricy S; From the Department of Neuroradiology (L.N., P.L., S.L.), La Pitié Salpêtrière University Hospital, Assistance publique-hôpitaux de Paris, Paris, France.; Center for NeuroImaging Research (S.L.), Paris Brain Institute, Paris, France.; The Paris Brain Institute (L.N., C.C., B.M., M.T., M.S., F. Bielle, S.L., F. Branzoli), Sorbonne University, Institut national de la santé et de la Recherche Médicale 1127, Centre National de la Recherche Scientifique, Joint Research Unit 7225, Equipe Labellisée Ligue Nationale Contre le Cancer, Paris, France., Branzoli F; The Paris Brain Institute (L.N., C.C., B.M., M.T., M.S., F. Bielle, S.L., F. Branzoli), Sorbonne University, Institut national de la santé et de la Recherche Médicale 1127, Centre National de la Recherche Scientifique, Joint Research Unit 7225, Equipe Labellisée Ligue Nationale Contre le Cancer, Paris, France.
Jazyk:	angličtina
Zdroj:	AJNR. American journal of neuroradiology [AJNR Am J Neuroradiol] 2024 Oct 31. Date of Electronic Publication: 2024 Oct 31.
DOI:	10.3174/ajnr.A8413
Abstrakt:	Background and Purpose: Isocitrate dehydrogenase ( IDH ) mutation and 1p/19q codeletion classify adult-type diffuse gliomas into 3 tumor subtypes with distinct prognoses. We aimed to evaluate the performance of edited MR spectroscopy for glioma subtyping in a clinical setting, via the quantification of D-2-hydroxyglutarate (2HG) and cystathionine. The delay between this noninvasive classification and the integrated histomolecular analysis was also quantified. Materials and Methods: Subjects with presumed low-grade gliomas eligible for surgery (cohort 1) and subjects with IDH -mutant gliomas previously treated and with progressive disease (cohort 2) were prospectively examined with a single-voxel Mescher-Garwood point-resolved spectroscopy sequence at 3T. Spectra were quantified using LCModel. The Cramér-Rao lower bounds threshold was set to 20%. Integrated histomolecular analysis according to the 2021 WHO classification was considered as ground truth. Results: Thirty-four consecutive subjects were enrolled. Due to poor spectra quality and lack of histologic specimens, data from 26 subjects were analyzed. Twenty-one belonged to cohort 1 (11 women; median age, 42 years); and 5, to cohort 2 (3 women; median age, 48 years). Edited MR spectroscopy showed 100% specificity for detection of IDH -mutation and 91% specificity for the prediction of 1p/19q-codeletion status. Sensitivities for the prediction of IDH and 1p/19q codeletion were 69% and 33%, respectively. The median Cramér-Rao lower bounds values were 16% (13%-28%) for IDH -mutant and 572% (554%-999%) for IDH wild type tumors. The time between MR spectroscopy and surgery was longer for low-grade than for high-grade gliomas ( P  = .03), yet the time between MR spectroscopy and WHO diagnosis did not differ between grades ( P  = .07), possibly reflecting molecular analyses-induced delays in high-grade gliomas. Conclusions: Our results, acquired in a clinic setting, confirmed that edited MR spectroscopy is highly specific for both IDH- mutation and 1p/19q-codeletion predictions and can provide a faster prognosis stratification. In the upcoming IDH-inhibitor treatment era, incorporation of edited MR spectroscopy into clinical workflow is desirable. (© 2025 by American Journal of Neuroradiology.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu