2-Hydroxyglutarate as an MR spectroscopic predictor of an IDH mutation in gliomas

Jochen Bauer; Heiner N. Raum; Harald Kugel; Michael Müther; Manoj Mannil; Walter Heindel

doi:10.1055/a-2285-4923

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, Table of Contents

Rofo 2024; 196(12): 1228-1235
DOI: 10.1055/a-2285-4923

Review

2-Hydroxyglutarat als MR-spektroskopisch erfassbarer Prädiktor einer IDH-Mutation bei Gliomen

Article in several languages: English | deutsch

Authors

Jochen Bauer

¹Clinic for Radiology, University of Münster and University Hospital Münster, Münster, Germany (Ringgold ID: RIN39069)
Heiner N. Raum

¹Clinic for Radiology, University of Münster and University Hospital Münster, Münster, Germany (Ringgold ID: RIN39069)
Harald Kugel

¹Clinic for Radiology, University of Münster and University Hospital Münster, Münster, Germany (Ringgold ID: RIN39069)
Michael Müther

²Department of Neurosurgery, University of Münster and University Hospital Münster, Münster, Germany (Ringgold ID: RIN39069)
Manoj Mannil

¹Clinic for Radiology, University of Münster and University Hospital Münster, Münster, Germany (Ringgold ID: RIN39069)

³Institute for Diagnostic and Interventional Radiology, Caritas Hospital Bad Mergentheim, Bad Mergentheim, Germany (Ringgold ID: RIN39646)
Walter Heindel

¹Clinic for Radiology, University of Münster and University Hospital Münster, Münster, Germany (Ringgold ID: RIN39069)

Abstract

Zusammenfassung

Hintergrund

Das mutierte Enzym Isocitrat-Dehydrogenase (IDH) 1 und 2 wurde in verschiedenen Tumorentitäten wie z.B. Gliomen nachgewiesen und kann α-Ketoglurat in den Onkometaboliten 2-Hydroxyglutarat (2-HG) konvertieren. Dieses neuroonkologisch bedeutsame Stoffwechselprodukt ist MR-spektroskopisch nachweisbar und eignet sich deshalb zur nichtinvasiven Gliomklassifizierung und Therapieüberwachung.

Methode

Die vorliegende Arbeit gibt einen aktuellen Überblick über die Methodik und Relevanz der ¹H-MR-Spektroskopie (MRS) in der onkologischen Primär- und Verlaufsdiagnostik von Gliomen. Anhand der verfügbaren Literatur werden die Möglichkeiten und Grenzen dieser MR-spektroskopischen Untersuchung beleuchtet.

Ergebnisse und Schlussfolgerung

Die MRS kann durch den Nachweis von 2-HG prinzipiell eine nicht-invasive Alternative zur immunhistologischen Analyse bieten und so in einigen Fällen einen operativen Eingriff vermeiden. Neben einem angepassten und optimierten Untersuchungsprotokoll sind aber die individuellen in der Untersuchungsregion vorliegenden Messbedingungen von entscheidender Bedeutung. Aufgrund des inhärent kleinen Signals von 2-HG können ungünstige Messbedingungen die Nachweissicherheit beeinflussen.

Kernaussagen

MR-Spektroskopie ermöglicht die nicht-invasive Detektion von 2-Hydroxyglutarat.
Hiermit ist der Nachweis einer IDH-Mutation in Gliomen möglich.
Besondere Bedeutung kommt der Wahl der MRS-Untersuchungsmethodik zu.
Die Detektionssicherheit wird beeinflusst von Gliomgröße, nekrotischem Gewebe und den vorliegenden Messbedingungen.

Zitierweise

Bauer J, Raum HN, Kugel H et al. 2-Hydroxyglutarate as an MR spectroscopic predictor of an IDH mutation in gliomas. Fortschr Röntgenstr 2024; DOI 10.1055/a-2285-4923

Schlüsselwörter

brain - MR-spectroscopy - technical aspects - tissue characterization - glioma - metabolism

Full Text

References

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