Autor: |
Tietze, Anna, Choi, Changho, Mickey, Bruce, Maher, Elizabeth, Ulhøi, Benedicte Parm, Sangill, Ryan, Lassen, Yasmin Alexandra, Lukácová, Slávka, Østergaard, Leif, Oettingen, Gorm von |
Jazyk: |
angličtina |
Rok vydání: |
2017 |
Zdroj: |
Tietze, A, Choi, C, Mickey, B, Maher, E, Ulhøi, B P, Sangill, R, Lassen, Y A, Lukácová, S, Østergaard, L & Oettingen, G V 2017, ' Non-invasive assessment of Isocitrate dehydrogenase (IDH) mutational status in cerebral gliomas by Magnetic Resonance Spectroscopy in a clinical setting ', Journal of Neurosurgery . |
Popis: |
Background: Mutations in the Isocitrate Dehydrogenase (IDH) gene are of proven diagnostic and prognostic significance for cerebral gliomas. We evaluated the clinical feasibility of using a recently described method for determining IDH mutational status by using Magnetic Resonance Spectroscopy (MRS) to detect the presence of 2-hydroxyglutarate (2HG), the metabolic product of the mutant IDH enzyme. Material&Methods: By extending our imaging time by 6 minutes, we were able to include a point-resolved spectroscopy (PRESS) MRS sequence in our routine glioma imaging protocol. Of 35 patients imaged, 30 were subsequently diagnosed histologically as gliomas. Of the remaining 5 patients, one had a gangliocytoma, one a primary CNS lymphoma, and 3 had non-neoplastic lesions. Immunohistochemistry and/or polymerase chain reaction (PCR) were used to detect the presence of IDH mutations in the glioma tissue resected. Results: In vivo MRS for 2HG correctly identified the IDH mutational status in 88.6% of patients. The sensitivity and specificity was 89.5% and 81.3%, respectively, when using 2mM 2HG as threshold to discriminate IDH-mutated from wildtype tumors. Two glioblastomas that had elevated 2HG levels did not have detectable IDH-mutations, and in two IDH mutated gliomas 2HG was not reliably detectable. Conclusion: The non-invasive determination of the IDH mutational status of a presumed glioma by means of MRS may be incorporated into a routine diagnostic imaging protocol and can be used to obtain additional information for patient care. |
Databáze: |
OpenAIRE |
Externí odkaz: |
|