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Zhou M, Nie Z, Zhao J, Xiao Y, Hong X, Wang Y, Dong C, Lin AP, Lei Z. Optimization and validation of echo times of point-resolved spectroscopy for cystathionine detection in gliomas. Cancer Imaging 2024; 24:118. [PMID: 39223589 PMCID: PMC11367870 DOI: 10.1186/s40644-024-00764-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 08/22/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Cystathionine accumulates selectively in 1p/19q-codeleted gliomas, and can serve as a possible noninvasive biomarker. This study aims to optimize the echo time (TE) of point-resolved spectroscopy (PRESS) for cystathionine detection in gliomas, and evaluate the diagnostic accuracy of PRESS for 1p/19q-codeletion identification. METHODS The TE of PRESS was optimized with numerical and phantom analysis to better resolve cystathionine from the overlapping aspartate multiplets. The optimized and 97 ms TE PRESS were then applied to 84 prospectively enrolled patients suspected of glioma or glioma recurrence to examine the influence of aspartate on cystathionine quantification by fitting the spectra with and without aspartate. The diagnostic performance of PRESS for 1p/19q-codeleted gliomas were assessed. RESULTS The TE of PRESS was optimized as (TE1, TE2) = (17 ms, 28 ms). The spectral pattern of cystathionine and aspartate were consistent between calculation and phantom. The mean concentrations of cystathionine in vivo fitting without aspartate were significantly higher than those fitting with full basis-set for 97 ms TE PRESS (1.97 ± 2.01 mM vs. 1.55 ± 1.95 mM, p < 0.01), but not significantly different for 45 ms method (0.801 ± 1.217 mM and 0.796 ± 1.217 mM, p = 0.494). The cystathionine concentrations of 45 ms approach was better correlated with those of edited MRS than 97 ms counterparts (r = 0.68 vs. 0.49, both p < 0.01). The sensitivity and specificity for discriminating 1p/19q-codeleted gliomas were 66.7% and 73.7% for 45 ms method, and 44.4% and 52.5% for 97 ms method, respectively. CONCLUSION The 45 ms TE PRESS yields more precise cystathionine estimates than the 97 ms method, and is anticipated to facilitate noninvasive diagnosis of 1p/19q-codeleted gliomas, and treatment response monitoring in those patients. Medium diagnostic performance of PRESS for 1p/19q-codeleted gliomas were observed, and warrants further investigations.
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Affiliation(s)
- Min Zhou
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhuang Nie
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jie Zhao
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yao Xiao
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Center for Clinical Spectroscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Xiaohua Hong
- Tumor Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuhui Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chengjun Dong
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Alexander P Lin
- Center for Clinical Spectroscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ziqiao Lei
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Yu M, Ge Y, Wang Z, Zhang Y, Hou X, Chen H, Chen X, Ji N, Li X, Shen H. The diagnostic efficiency of integration of 2HG MRS and IVIM versus individual parameters for predicting IDH mutation status in gliomas in clinical scenarios: A retrospective study. J Neurooncol 2024; 167:305-313. [PMID: 38424338 DOI: 10.1007/s11060-024-04609-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 02/16/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE Currently, there remains a scarcity of established preoperative tests to accurately predict the isocitrate dehydrogenase (IDH) mutation status in clinical scenarios, with limited research has explored the potential synergistic diagnostic performance among metabolite, perfusion, and diffusion parameters. To address this issue, we aimed to develop an imaging protocol that integrated 2-hydroxyglutarate (2HG) magnetic resonance spectroscopy (MRS) and intravoxel incoherent motion (IVIM) by comprehensively assessing metabolic, cellular, and angiogenic changes caused by IDH mutations, and explored the diagnostic efficiency of this imaging protocol for predicting IDH mutation status in clinical scenarios. METHODS Patients who met the inclusion criteria were categorized into two groups: IDH-wild type (IDH-WT) group and IDH-mutant (IDH-MT) group. Subsequently, we quantified the 2HG concentration, the relative apparent diffusion coefficient (rADC), the relative true diffusion coefficient value (rD), the relative pseudo-diffusion coefficient (rD*) and the relative perfusion fraction value (rf). Intergroup differences were estimated using t-test and Mann-Whitney U test. Finally, we performed receiver operating characteristic (ROC) curve and DeLong's test to evaluate and compare the diagnostic performance of individual parameters and their combinations. RESULTS 64 patients (female, 21; male, 43; age, 47.0 ± 13.7 years) were enrolled. Compared with IDH-WT gliomas, IDH-MT gliomas had higher 2HG concentration, rADC and rD (P < 0.001), and lower rD* (P = 0.013). The ROC curve demonstrated that 2HG + rD + rD* exhibited the highest areas under curve (AUC) value (0.967, 95%CI 0.889-0.996) for discriminating IDH mutation status. Compared with each individual parameter, the predictive efficiency of 2HG + rADC + rD* and 2HG + rD + rD* shows a statistically significant enhancement (DeLong's test: P < 0.05). CONCLUSIONS The integration of 2HG MRS and IVIM significantly improves the diagnostic efficiency for predicting IDH mutation status in clinical scenarios.
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Affiliation(s)
- Meimei Yu
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Radiology, The First People's Hospital of Longquanyi District, Chengdu, Sichuan Province, China
| | - Ying Ge
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Radiology, Beijing Huimin Hospital, Beijing, China
| | - Zixuan Wang
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yang Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xinyi Hou
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Hongyan Chen
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Xuzhu Chen
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Nan Ji
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xin Li
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huicong Shen
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China.
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de Godoy LL, Lim KC, Rajan A, Verma G, Hanaoka M, O’Rourke DM, Lee JYK, Desai A, Chawla S, Mohan S. Non-Invasive Assessment of Isocitrate Dehydrogenase-Mutant Gliomas Using Optimized Proton Magnetic Resonance Spectroscopy on a Routine Clinical 3-Tesla MRI. Cancers (Basel) 2023; 15:4453. [PMID: 37760422 PMCID: PMC10526791 DOI: 10.3390/cancers15184453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/22/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
PURPOSE The isocitrate dehydrogenase (IDH) mutation has become one of the most important prognostic biomarkers in glioma management, indicating better treatment response and prognosis. IDH mutations confer neomorphic activity leading to the conversion of alpha-ketoglutarate (α-KG) to 2-hydroxyglutarate (2HG). The purpose of this study was to investigate the clinical potential of proton MR spectroscopy (1H-MRS) in identifying IDH-mutant gliomas by detecting characteristic resonances of 2HG and its complex interplay with other clinically relevant metabolites. MATERIALS AND METHODS Thirty-two patients with suspected infiltrative glioma underwent a single-voxel (SVS, n = 17) and/or single-slice-multivoxel (1H-MRSI, n = 15) proton MR spectroscopy (1H-MRS) sequence with an optimized echo-time (97 ms) on 3T-MRI. Spectroscopy data were analyzed using the linear combination (LC) model. Cramér-Rao lower bound (CRLB) values of <40% were considered acceptable for detecting 2HG and <20% for other metabolites. Immunohistochemical analyses for determining IDH mutational status were subsequently performed from resected tumor specimens and findings were compared with the results from spectral data. Mann-Whitney and chi-squared tests were performed to ascertain differences in metabolite levels between IDH-mutant and IDH-wild-type gliomas. Receiver operating characteristic (ROC) curve analyses were also performed. RESULTS Data from eight cases were excluded due to poor spectral quality or non-tumor-related etiology, and final data analyses were performed from 24 cases. Of these cases, 9/12 (75%) were correctly identified as IDH-mutant or IDH-wildtype gliomas through SVS and 10/12 (83%) through 1H-MRSI with an overall concordance rate of 79% (19/24). The sensitivity, specificity, positive predictive value, and negative predictive value were 80%, 77%, 86%, and 70%, respectively. The metabolite 2HG was found to be significant in predicting IDH-mutant gliomas through the chi-squared test (p < 0.01). The IDH-mutant gliomas also had a significantly higher NAA/Cr ratio (1.20 ± 0.09 vs. 0.75 ± 0.12 p = 0.016) and lower Glx/Cr ratio (0.86 ± 0.078 vs. 1.88 ± 0.66; p = 0.029) than those with IDH wild-type gliomas. The areas under the ROC curves for NAA/Cr and Glx/Cr were 0.808 and 0.786, respectively. CONCLUSIONS Noninvasive optimized 1H-MRS may be useful in predicting IDH mutational status and 2HG may serve as a valuable diagnostic and prognostic biomarker in patients with gliomas.
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Affiliation(s)
- Laiz Laura de Godoy
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA; (L.L.d.G.); (A.R.); (M.H.); (S.M.)
| | - Kheng Choon Lim
- Department of Neuroradiology, Singapore General Hospital, Singapore 169609, Singapore;
| | - Archith Rajan
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA; (L.L.d.G.); (A.R.); (M.H.); (S.M.)
| | - Gaurav Verma
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Mauro Hanaoka
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA; (L.L.d.G.); (A.R.); (M.H.); (S.M.)
| | - Donald M. O’Rourke
- Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA; (D.M.O.); (J.Y.K.L.)
- Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA;
- Glioblastoma Translational Center of Excellence, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19014, USA
| | - John Y. K. Lee
- Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA; (D.M.O.); (J.Y.K.L.)
- Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA;
- Glioblastoma Translational Center of Excellence, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19014, USA
| | - Arati Desai
- Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA;
- Glioblastoma Translational Center of Excellence, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19014, USA
| | - Sanjeev Chawla
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA; (L.L.d.G.); (A.R.); (M.H.); (S.M.)
| | - Suyash Mohan
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA; (L.L.d.G.); (A.R.); (M.H.); (S.M.)
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Di Stefano AL, Nichelli L, Berzero G, Valabregue R, Touat M, Capelle L, Pontoizeau C, Bielle F, Lerond J, Giry M, Villa C, Baussart B, Dehais C, Galanaud D, Baldini C, Savatovsky J, Dhermain F, Deelchand DK, Ottolenghi C, Lehéricy S, Marjańska M, Branzoli F, Sanson M. In Vivo 2-Hydroxyglutarate Monitoring With Edited MR Spectroscopy for the Follow-up of IDH-Mutant Diffuse Gliomas: The IDASPE Prospective Study. Neurology 2023; 100:e94-e106. [PMID: 36180241 PMCID: PMC9827125 DOI: 10.1212/wnl.0000000000201137] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 07/05/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND AND OBJECTIVES D-2-hydroxyglutarate (2HG) characterizes IDH-mutant gliomas and can be detected and quantified with edited MRS (MEGA-PRESS). In this study, we investigated the clinical, radiologic, and molecular parameters affecting 2HG levels. METHODS MEGA-PRESS data were acquired in 71 patients with glioma (24 untreated, 47 treated) on a 3 T system. Eighteen patients were followed during cytotoxic (n = 12) or targeted (n = 6) therapy. 2HG was measured in tumor samples using gas chromatography coupled to mass spectrometry (GCMS). RESULTS MEGA-PRESS detected 2HG with a sensitivity of 95% in untreated patients and 62% in treated patients. Sensitivity depended on tumor volume (>27 cm3; p = 0.02), voxel coverage (>75%; p = 0.002), and expansive presentation (defined by equal size of T1 and FLAIR abnormalities, p = 0.04). 2HG levels were positively correlated with IDH-mutant allelic fraction (p = 0.03) and total choline levels (p < 0.001) and were higher in IDH2-mutant compared with IDH1 R132H-mutant and non-R132H IDH1-mutant patients (p = 0.002). In patients receiving IDH inhibitors, 2HG levels decreased within a few days, demonstrating the on-target effect of the drug, but 2HG level decrease did not predict tumor response. Patients receiving cytotoxic treatments showed a slower decrease in 2HG levels, consistent with tumor response and occurring before any tumor volume change on conventional MRI. At progression, 1p/19q codeleted gliomas, but not the non-codeleted, showed detectable in vivo 2HG levels, pointing out to different modes of progression characterizing these 2 entities. DISCUSSION MEGA-PRESS edited MRS allows in vivo monitoring of 2-hydroxyglutarate, confirming efficacy of IDH inhibition and suggests different patterns of tumor progression in astrocytomas compared with oligodendrogliomas.
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Affiliation(s)
- Anna Luisa Di Stefano
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Lucia Nichelli
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Giulia Berzero
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Romain Valabregue
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Mehdi Touat
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Laurent Capelle
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Clément Pontoizeau
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Franck Bielle
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Julie Lerond
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Marine Giry
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Chiara Villa
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Bertrand Baussart
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Caroline Dehais
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Damien Galanaud
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Capucine Baldini
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Julien Savatovsky
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Frédéric Dhermain
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Dinesh K Deelchand
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Chris Ottolenghi
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Stéphane Lehéricy
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Małgorzata Marjańska
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Francesca Branzoli
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France
| | - Marc Sanson
- From the Sorbonne Université (A.L.D.S.,M.D.P.D., L.N., M.D.P.D., J.L., M.G., S.L., Francesca Branzoli), Inserm, CNRS, Paris Brain Institute-Institut du Cerveau (ICM), Paris, France. Equipe labellisée LNCC; Service de Neurologie 2-Mazarin (A.L.D.S.,M.D.P.D., M.D.P.D., C.D.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Neuroradiologie Diagnostique et Interventionnelle (L.N., D.G., S.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Neurology Unit (G.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy; Centre de NeuroImagerie de Recherche (CENIR) (R.V., S.L., Francesca Branzoli), Institut du Cerveau (ICM), Paris, France; Service de Neurochirurgie (L.C., B.B.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Service de Biochimie Métabolique (C.P.), AP-HP, Hôpital Necker, Paris, France; Laboratoire R Escourolle (J.L.), AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France; Drug Development Department (DITEP) (C.B.), Gustave Roussy, Villejuif, France; Service de Radiologie (J.S.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Radiotherapy Department (F.D.), Gustave Roussy University Hospital, Villejuif, Cedex, France; Center for Magnetic Resonance Research (D.K.D., M.M.), Department of Radiology, Minneapolis, MN; and OncoNeuroTek Tumor Bank (M.D.P.D.), Institut du Cerveau et de la Moelle épinière (ICM), Paris, France.
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5
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Wang D, Li X, Gong G, Lu Y, Guo Z, Chen R, Huang H, Li Z, Bian J. An updated patent review of glutaminase inhibitors (2019-2022). Expert Opin Ther Pat 2023; 33:17-28. [PMID: 36698323 DOI: 10.1080/13543776.2023.2173573] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Kidney-type glutaminase (GLS1), a key enzyme controlling the hydrolysis of glutamine to glutamate to resolve the 'glutamine addiction' of cancer cells, has been shown to play a central role in supporting cancer growth and proliferation. Therefore, the inhibition of GLS1 as a novel cancer treating strategy is of great interest. AREAS COVERED This review covers recent patents (2019-present) involving GLS1 inhibitors, which are mostly focused on their chemical structures, molecular mechanisms of action, pharmacokinetic properties, and potential clinical applications. EXPERT OPINION Currently, despite significant efforts, the search for potent GLS1 inhibitors has not resulted in the development of compounds for therapeutic applications. Most recent patents and literature focus on GLS1 inhibitors IPN60090 and DRP104, which have entered clinical trials. While other patent disclosures during this period have not generated any drug candidates, the clinical update will inform the potential of these inhibitors as promising therapeutic agents either as single or as combination interventions.
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Affiliation(s)
- Danni Wang
- State Key Laboratory of Natural Medicines and Jiang Su Key Laboratory of Drug Design and Optimization, Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Xiaohong Li
- State Key Laboratory of Natural Medicines and Jiang Su Key Laboratory of Drug Design and Optimization, Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Guangyue Gong
- State Key Laboratory of Natural Medicines and Jiang Su Key Laboratory of Drug Design and Optimization, Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Yulong Lu
- State Key Laboratory of Natural Medicines and Jiang Su Key Laboratory of Drug Design and Optimization, Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Ziming Guo
- State Key Laboratory of Natural Medicines and Jiang Su Key Laboratory of Drug Design and Optimization, Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Rui Chen
- State Key Laboratory of Natural Medicines and Jiang Su Key Laboratory of Drug Design and Optimization, Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Huidan Huang
- Department of Pharmaceutical Engineering, School of Pharmacy, Wannan Medical College, Wuhu, China
| | - Zhiyu Li
- State Key Laboratory of Natural Medicines and Jiang Su Key Laboratory of Drug Design and Optimization, Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Jinlei Bian
- State Key Laboratory of Natural Medicines and Jiang Su Key Laboratory of Drug Design and Optimization, Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing, China
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Najac C, Boer VO, Kan HE, Webb AG, Ronen I. Improved detection limits of J-coupled neurometabolites in the human brain at 7 T with a J-refocused sLASER sequence. NMR IN BIOMEDICINE 2022; 35:e4801. [PMID: 35833462 PMCID: PMC9788253 DOI: 10.1002/nbm.4801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 07/02/2022] [Accepted: 07/12/2022] [Indexed: 06/15/2023]
Abstract
In a standard spin echo, the time evolution due to homonuclear couplings is not reversed, leading to echo time (TE)-dependent modulation of the signal amplitude and signal loss in the case of overlapping multiplet resonances. This has an adverse effect on quantification of several important metabolites such as glutamate and glutamine. Here, we propose a J-refocused variant of the sLASER sequence (J-sLASER) to improve quantification of J-coupled metabolites at ultrahigh field (UHF). The use of the sLASER sequence is particularly advantageous at UHF as it minimizes chemical shift displacement error and results in relatively homogenous refocusing. We simulated the MRS signal from brain metabolites over a broad range of TE values with sLASER and J-sLASER, and showed that the signal of J-coupled metabolites was increased with J-sLASER with TE values up to ~80 ms. We further simulated "brain-like" spectra with both sequences at the shortest TE available on our scanner. We showed that, despite the slightly longer TE, the J-sLASER sequence results in significantly lower Cramer-Rao lower bounds (CRLBs) for J-coupled metabolites compared with those obtained with sLASER. Following phantom validation, we acquired spectra from two brain regions in 10 healthy volunteers (age 38 ± 15 years) using both sequences. We showed that using J-sLASER results in a decrease of CRLBs for J-coupled metabolites. In particular, we measured a robust ~38% decrease in the mean CRLB (glutamine) in parietal white matter and posterior cingulate cortex (PCC). We further showed, in 10 additional healthy volunteers (age 34 ± 15 years), that metabolite quantification following two separate acquisitions with J-sLASER in the PCC was repeatable. The improvement in quantification of glutamine may in turn improve the independent quantification of glutamate, the main excitatory neurotransmitter in the brain, and will simultaneously help to track possible modulations of glutamine, which is a key player in the glutamatergic cycle in astrocytes.
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Affiliation(s)
- Chloé Najac
- C. J. Gorter Center for High Field MRI, Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Vincent O. Boer
- Danish Research Centre for Magnetic ResonanceCopenhagen University Hospital HvidovreHvidovreDenmark
| | - Hermien E. Kan
- C. J. Gorter Center for High Field MRI, Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Andrew G. Webb
- C. J. Gorter Center for High Field MRI, Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Itamar Ronen
- C. J. Gorter Center for High Field MRI, Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
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7
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McCarthy L, Verma G, Hangel G, Neal A, Moffat BA, Stockmann JP, Andronesi OC, Balchandani P, Hadjipanayis CG. Application of 7T MRS to High-Grade Gliomas. AJNR Am J Neuroradiol 2022; 43:1378-1395. [PMID: 35618424 PMCID: PMC9575545 DOI: 10.3174/ajnr.a7502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 02/11/2022] [Indexed: 01/26/2023]
Abstract
MRS, including single-voxel spectroscopy and MR spectroscopic imaging, captures metabolites in high-grade gliomas. Emerging evidence indicates that 7T MRS may be more sensitive to aberrant metabolic activity than lower-field strength MRS. However, the literature on the use of 7T MRS to visualize high-grade gliomas has not been summarized. We aimed to identify metabolic information provided by 7T MRS, optimal spectroscopic sequences, and areas for improvement in and new applications for 7T MRS. Literature was found on PubMed using "high-grade glioma," "malignant glioma," "glioblastoma," "anaplastic astrocytoma," "7T," "MR spectroscopy," and "MR spectroscopic imaging." 7T MRS offers higher SNR, modestly improved spatial resolution, and better resolution of overlapping resonances. 7T MRS also yields reduced Cramér-Rao lower bound values. These features help to quantify D-2-hydroxyglutarate in isocitrate dehydrogenase 1 and 2 gliomas and to isolate variable glutamate, increased glutamine, and increased glycine with higher sensitivity and specificity. 7T MRS may better characterize tumor infiltration and treatment effect in high-grade gliomas, though further study is necessary. 7T MRS will benefit from increased sample size; reductions in field inhomogeneity, specific absorption rate, and acquisition time; and advanced editing techniques. These findings suggest that 7T MRS may advance understanding of high-grade glioma metabolism, with reduced Cramér-Rao lower bound values and better measurement of smaller metabolite signals. Nevertheless, 7T is not widely used clinically, and technical improvements are necessary. 7T MRS isolates metabolites that may be valuable therapeutic targets in high-grade gliomas, potentially resulting in wider ranging neuro-oncologic applications.
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Affiliation(s)
- L McCarthy
- From the Department of Neurosurgery (L.M., C.G.H.), Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York
| | - G Verma
- BioMedical Engineering and Imaging Institute (G.V., P.B.), Icahn School of Medicine at Mount Sinai, New York, New York
| | - G Hangel
- Department of Neurosurgery (G.H.)
- High-field MR Center (G.H.), Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - A Neal
- Department of Medicine (A.N.), Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia
- Department of Neurology (A.N.), Royal Melbourne Hospital, Melbourne, Australia
| | - B A Moffat
- The Melbourne Brain Centre Imaging Unit (B.A.M.), Department of Radiology, The University of Melbourne, Melbourne, Australia
| | - J P Stockmann
- A. A. Martinos Center for Biomedical Imaging (J.P.S., O.C.A.), Massachusetts General Hospital, Charlestown, Massachusetts
- Harvard Medical School (J.P.S., O.C.A.), Boston, Massachusetts
| | - O C Andronesi
- A. A. Martinos Center for Biomedical Imaging (J.P.S., O.C.A.), Massachusetts General Hospital, Charlestown, Massachusetts
- Harvard Medical School (J.P.S., O.C.A.), Boston, Massachusetts
| | - P Balchandani
- BioMedical Engineering and Imaging Institute (G.V., P.B.), Icahn School of Medicine at Mount Sinai, New York, New York
| | - C G Hadjipanayis
- From the Department of Neurosurgery (L.M., C.G.H.), Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York
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Strasser B, Arango NS, Stockmann JP, Gagoski B, Thapa B, Li X, Bogner W, Moser P, Small J, Cahill DP, Batchelor TT, Dietrich J, van der Kouwe A, White J, Adalsteinsson E, Andronesi OC. Improving D-2-hydroxyglutarate MR spectroscopic imaging in mutant isocitrate dehydrogenase glioma patients with multiplexed RF-receive/B 0 -shim array coils at 3 T. NMR IN BIOMEDICINE 2022; 35:e4621. [PMID: 34609036 PMCID: PMC8717863 DOI: 10.1002/nbm.4621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 06/13/2023]
Abstract
MR spectroscopic imaging (MRSI) noninvasively maps the metabolism of human brains. In particular, the imaging of D-2-hydroxyglutarate (2HG) produced by glioma isocitrate dehydrogenase (IDH) mutations has become a key application in neuro-oncology. However, the performance of full field-of-view MRSI is limited by B0 spatial nonuniformity and lipid artifacts from tissues surrounding the brain. Array coils that multiplex RF-receive and B0 -shim electrical currents (AC/DC mixing) over the same conductive loops provide many degrees of freedom to improve B0 uniformity and reduce lipid artifacts. AC/DC coils are highly efficient due to compact design, requiring low shim currents (<2 A) that can be switched fast (0.5 ms) with high interscan reproducibility (10% coefficient of variation for repeat measurements). We measured four tumor patients and five volunteers at 3 T and show that using AC/DC coils in addition to the vendor-provided second-order spherical harmonics shim provides 19% narrower spectral linewidth, 6% higher SNR, and 23% less lipid content for unrestricted field-of-view MRSI, compared with the vendor-provided shim alone. We demonstrate that improvement in MRSI data quality led to 2HG maps with higher contrast-to-noise ratio for tumors that coincide better with the FLAIR-enhancing lesions in mutant IDH glioma patients. Smaller Cramér-Rao lower bounds for 2HG quantification are obtained in tumors by AC/DC shim, corroborating with simulations that predicted improved accuracy and precision for narrower linewidths. AC/DC coils can be used synergistically with optimized acquisition schemes to improve metabolic imaging for precision oncology of glioma patients. Furthermore, this methodology has broad applicability to other neurological disorders and neuroscience.
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Affiliation(s)
- Bernhard Strasser
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Radiology, Boston, Massachusetts, USA
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Vienna, Austria
| | - Nicolas S. Arango
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Jason P. Stockmann
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Radiology, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Borjan Gagoski
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, Boston, Massachusetts, USA
- Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
| | - Bijaya Thapa
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Radiology, Boston, Massachusetts, USA
| | - Xianqi Li
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Radiology, Boston, Massachusetts, USA
| | - Wolfgang Bogner
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Vienna, Austria
| | - Philipp Moser
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Vienna, Austria
| | - Julia Small
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Daniel P. Cahill
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Tracy T. Batchelor
- Department Neurology, Division of Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jorg Dietrich
- Department Neurology, Division of Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Andre van der Kouwe
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Radiology, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Jacob White
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Elfar Adalsteinsson
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Ovidiu C. Andronesi
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Radiology, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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Natsumeda M, Igarashi H, Gabdulkhaev R, Takahashi H, Motohashi K, Ogura R, Watanabe J, Tsukamoto Y, Okamoto K, Kakita A, Nakada T, Fujii Y. Detection of 2-Hydroxyglutarate by 3.0-Tesla Magnetic Resonance Spectroscopy in Gliomas with Rare IDH Mutations: Making Sense of "False-Positive" Cases. Diagnostics (Basel) 2021; 11:2129. [PMID: 34829476 PMCID: PMC8619588 DOI: 10.3390/diagnostics11112129] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 11/15/2021] [Indexed: 11/20/2022] Open
Abstract
We have previously published a study on the reliable detection of 2-hydroxyglutarate (2HG) in lower-grade gliomas by magnetic resonance spectroscopy (MRS). In this short article, we re-evaluated five glioma cases originally assessed as isocitrate dehydrogenase (IDH) wildtype, which showed a high accumulation of 2HG, and were thought to be false-positives. A new primer was used for the detection of IDH2 mutation by Sanger sequencing. Adequate tissue for DNA analysis was available in 4 out of 5 cases. We found rare IDH2 mutations in two cases, with IDH2 R172W mutation in one case and IDH2 R172K mutation in another case. Both cases had very small mutant peaks, suggesting that the tumor volume was low in the tumor samples. Thus, the specificity of MRS for detecting IDH1/2 mutations was higher (81.3%) than that originally reported (72.2%). The detection of 2HG by MRS can aid in the diagnosis of rare, non-IDH1-R132H IDH1 and IDH2 mutations in gliomas.
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Affiliation(s)
- Manabu Natsumeda
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata 951-8122, Japan; (H.T.); (K.M.); (R.O.); (J.W.); (Y.T.); (Y.F.)
| | - Hironaka Igarashi
- Center for Integrated Brain Sciences, Brain Research Institute, Niigata University, Niigata 951-8585, Japan;
| | - Ramil Gabdulkhaev
- Department of Pathology, Brain Research Institute, Niigata University, Niigata 951-8585, Japan; (R.G.); (A.K.)
| | - Haruhiko Takahashi
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata 951-8122, Japan; (H.T.); (K.M.); (R.O.); (J.W.); (Y.T.); (Y.F.)
| | - Kunio Motohashi
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata 951-8122, Japan; (H.T.); (K.M.); (R.O.); (J.W.); (Y.T.); (Y.F.)
| | - Ryosuke Ogura
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata 951-8122, Japan; (H.T.); (K.M.); (R.O.); (J.W.); (Y.T.); (Y.F.)
| | - Jun Watanabe
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata 951-8122, Japan; (H.T.); (K.M.); (R.O.); (J.W.); (Y.T.); (Y.F.)
| | - Yoshihiro Tsukamoto
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata 951-8122, Japan; (H.T.); (K.M.); (R.O.); (J.W.); (Y.T.); (Y.F.)
| | - Kouichirou Okamoto
- Department of Translational Research, Brain Research Institute, Niigata University, Niigata 951-8585, Japan;
| | - Akiyoshi Kakita
- Department of Pathology, Brain Research Institute, Niigata University, Niigata 951-8585, Japan; (R.G.); (A.K.)
| | - Tsutomu Nakada
- Center for Integrated Brain Sciences, Brain Research Institute, Niigata University, Niigata 951-8585, Japan;
| | - Yukihiko Fujii
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata 951-8122, Japan; (H.T.); (K.M.); (R.O.); (J.W.); (Y.T.); (Y.F.)
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10
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Miura N, Mushti C, Sail D, AbuSalim JE, Yamamoto K, Brender JR, Seki T, AbuSalim DI, Matsumoto S, Camphausen KA, Krishna MC, Swenson RE, Kesarwala AH. Synthesis of [1- 13 C-5- 12 C]-alpha-ketoglutarate enables noninvasive detection of 2-hydroxyglutarate. NMR IN BIOMEDICINE 2021; 34:e4588. [PMID: 34263489 PMCID: PMC8492538 DOI: 10.1002/nbm.4588] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/22/2021] [Accepted: 06/22/2021] [Indexed: 06/13/2023]
Abstract
Isocitrate dehydrogenase 1 (IDH1) mutations that generate the oncometabolite 2-hydroxyglutarate (2-HG) from α-ketoglutarate (α-KG) have been identified in many types of tumors and are an important prognostic factor in gliomas. 2-HG production can be determined by hyperpolarized carbon-13 magnetic resonance spectroscopy (HP-13 C-MRS) using [1-13 C]-α-KG as a probe, but peak contamination from naturally occurring [5-13 C]-α-KG overlaps with the [1-13 C]-2-HG peak. Via a newly developed oxidative-Stetter reaction, [1-13 C-5-12 C]-α-KG was synthesized. α-KG metabolism was measured via HP-13 C-MRS using [1-13 C-5-12 C]-α-KG as a probe. [1-13 C-5-12 C]-α-KG was synthesized in high yields, and successfully eliminated the signal from C5 of α-KG in the HP-13 C-MRS spectra. In HCT116 IDH1 R132H cells, [1-13 C-5-12 C]-α-KG allowed for unimpeded detection of [1-13 C]-2-HG. 12 C-enrichment represents a novel method to circumvent spectral overlap, and [1-13 C-5-12 C]-α-KG shows promise as a probe to study IDH1 mutant tumors and α-KG metabolism.
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Affiliation(s)
- Natsuko Miura
- Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Chandrasekhar Mushti
- Chemistry and Synthesis Center, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Deepak Sail
- Chemistry and Synthesis Center, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jenna E. AbuSalim
- Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
- Department of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA
| | - Kazutoshi Yamamoto
- Radiation Biology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jeffrey R. Brender
- Radiation Biology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Tomohiro Seki
- Radiation Biology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Shingo Matsumoto
- Radiation Biology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kevin A. Camphausen
- Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Murali C. Krishna
- Radiation Biology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Rolf E. Swenson
- Chemistry and Synthesis Center, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Aparna H. Kesarwala
- Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
- Department of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA
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11
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Askari P, Dimitrov IE, Ganji SK, Tiwari V, Levy M, Patel TR, Pan E, Mickey BE, Malloy CR, Maher EA, Choi C. Spectral fitting strategy to overcome the overlap between 2-hydroxyglutarate and lipid resonances at 2.25 ppm. Magn Reson Med 2021; 86:1818-1828. [PMID: 33977579 PMCID: PMC8295210 DOI: 10.1002/mrm.28829] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/07/2021] [Accepted: 04/15/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE 1 H MRS provides a noninvasive tool for identifying mutations in isocitrate dehydrogenase (IDH). Quantification of the prominent 2-hydroxyglutarate (2HG) resonance at 2.25 ppm is often confounded by the lipid resonance at the same frequency in tumors with elevated lipids. We propose a new spectral fitting approach to separate these overlapped signals, therefore, improving 2HG evaluation. METHODS TE 97 ms PRESS was acquired at 3T from 42 glioma patients. New lipid basis sets were created, in which the small lipid 2.25-ppm signal strength was preset with reference to the lipid signal at 0.9 ppm, incorporating published fat relaxation data. LCModel fitting using the new lipid bases (Fitting method 2) was conducted along with fitting using the LCModel built-in lipid basis set (Fitting method 1), in which the lipid 2.25-ppm signal is assessed with reference to the lipid 1.3-ppm signal. In-house basis spectra of low-molecular-weight metabolites were used in both fitting methods. RESULTS Fitting method 2 showed marked improvement in identifying IDH mutational status compared with Fitting method 1. 2HG estimates from Fitting method 2 were overall smaller than those from Fitting method 1, which was because of differential assignment of the signal at 2.25 ppm to lipids. In receiver operating characteristic analysis, Fitting method 2 provided a complete distinction between IDH mutation and wild-type whereas Fitting method 1 did not. CONCLUSION The data suggest that 1 H MR spectral fitting using the new lipid basis set provides a robust fitting strategy that improves 2HG evaluation in brain tumors with elevated lipids.
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Affiliation(s)
- Pegah Askari
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
- Joint Graduate Program in Biomedical Engineering at University of Texas Arlington and University of Texas Southwestern Medical Center, Texas
| | - Ivan E. Dimitrov
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
- Philips Healthcare, Gainesville, Florida
| | - Sandeep K. Ganji
- Philips Healthcare, Andover, Massachusetts
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Vivek Tiwari
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Michael Levy
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Toral R. Patel
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Edward Pan
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas
- Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Bruce E. Mickey
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
- Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
- Annette G. Strauss Center for Neuro-Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Craig R. Malloy
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
- Veterans Affairs North Texas Health Care System, Dallas, Texas
| | - Elizabeth A. Maher
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas
- Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
- Annette G. Strauss Center for Neuro-Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Changho Choi
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
- Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
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12
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Shams Z, van der Kemp WJM, Emir U, Dankbaar JW, Snijders TJ, de Vos FYF, Klomp DWJ, Wijnen JP, Wiegers EC. Comparison of 2-Hydroxyglutarate Detection With sLASER and MEGA-sLASER at 7T. Front Neurol 2021; 12:718423. [PMID: 34557149 PMCID: PMC8452903 DOI: 10.3389/fneur.2021.718423] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/05/2021] [Indexed: 12/15/2022] Open
Abstract
The onco-metabolite 2-hydroxyglutarate (2HG), a biomarker of IDH-mutant gliomas, can be detected with 1H MR spectroscopy (1H-MRS). Recent studies showed measurements of 2HG at 7T with substantial gain in signal to noise ratio (SNR) and spectral resolution, offering higher specificity and sensitivity for 2HG detection. In this study, we assessed the sensitivity of semi-localized by adiabatic selective refocusing (sLASER) and J-difference MEsher-GArwood-semi-LASER (MEGA-sLASER) for 2HG detection at 7T. We performed spectral editing at long TE using a TE-optimized sLASER sequence (110 ms) and J-difference spectroscopy using MEGA-sLASER (TE = 74ms) in phantoms with different 2HG concentrations to assess the sensitivity of 2HG detection. The robustness of the methods against B0 inhomogeneity was investigated. Moreover, the performance of these two techniques was evaluated in four patients with IDH1-mutated glioma. In contrary to MEGA-sLASER, sLASER was able to detect 2HG concentration as low as 0.5 mM. In case of a composite phantom containing 2HG with overlapping metabolites, MEGA-sLASER provided a clean 2HG signal with higher fitting reliability (lower %CRLB). The results demonstrate that sLASER is more robust against field inhomogeneities and experimental or motion-related artifacts which promotes to adopt sLASER in clinical implementations.
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Affiliation(s)
- Zahra Shams
- Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Uzay Emir
- School of Health Sciences, Purdue University, West Lafayette, IN, United States
| | - Jan Willem Dankbaar
- Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Tom J Snijders
- Department of Neurology & Neurosurgery, University Medical Center Utrecht/UMC Utrecht Brain Center, Utrecht, Netherlands
| | - Filip Y F de Vos
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Dennis W J Klomp
- Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Jannie P Wijnen
- Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Evita C Wiegers
- Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands
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13
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Asensio AF, Alvarez-González E, Rodríguez A, Sierra LM, Blanco-González E. Chromatographic methods coupled to mass spectrometry for the determination of oncometabolites in biological samples-A review. Anal Chim Acta 2021; 1177:338646. [PMID: 34482900 DOI: 10.1016/j.aca.2021.338646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 11/29/2022]
Abstract
It is now well-established that dysregulation of the tricarboxylic acid (TCA) cycle enzymes succinate dehydrogenase, fumarate hydratase, and isocitrate dehydrogenase leads to the abnormal cellular accumulation of succinate, fumarate, and 2-hydroxyglutarate, respectively, which contribute to the formation and malignant progression of numerous types of cancers. Thus, these metabolites, called oncometabolites, could potentially be useful as tumour-specific biomarkers and as therapeutic targets. For this reason, the development of analytical methodologies for the accurate identification and determination of their levels in biological matrices is an important task in the field of cancer research. Currently, hyphenated gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-mass spectrometry (LC-MS) techniques are the most powerful analytical tools in what concerns high sensitivity and selectivity to achieve such difficult task. In this review, we first provide a brief description of the biological formation of oncometabolites and their oncogenic properties, and then we present an overview and critical assessment of the GC-MS and LC-MS based analytical approaches that are reported in the literature for the determination of oncometabolites in biological samples, such as biofluids, cells, and tissues. Advantages and drawbacks of these approaches will be comparatively discussed. We believe that the present review represents the first attempt to summarize the applications of these hyphenated techniques in the context of oncometabolite analysis, which may be useful to new and existing researchers in this field.
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Affiliation(s)
- A Fernández Asensio
- Department of Physical and Analytical Chemistry, Faculty of Chemistry, Institute of Sanitary Research of Asturias (ISPA), University of Oviedo. C/ Julian Clavería 8, 33006, Oviedo. Spain; Department of Functional Biology (Genetic Area), Oncology University Institute (IUOPA) and Institute of Sanitary Research of Asturias (ISPA), University of Oviedo. C/ Julian Clavería s/n, 33006, Oviedo. Spain
| | - E Alvarez-González
- Department of Functional Biology (Genetic Area), Oncology University Institute (IUOPA) and Institute of Sanitary Research of Asturias (ISPA), University of Oviedo. C/ Julian Clavería s/n, 33006, Oviedo. Spain
| | - A Rodríguez
- Department of Functional Biology (Genetic Area), Oncology University Institute (IUOPA) and Institute of Sanitary Research of Asturias (ISPA), University of Oviedo. C/ Julian Clavería s/n, 33006, Oviedo. Spain
| | - L M Sierra
- Department of Functional Biology (Genetic Area), Oncology University Institute (IUOPA) and Institute of Sanitary Research of Asturias (ISPA), University of Oviedo. C/ Julian Clavería s/n, 33006, Oviedo. Spain
| | - E Blanco-González
- Department of Physical and Analytical Chemistry, Faculty of Chemistry, Institute of Sanitary Research of Asturias (ISPA), University of Oviedo. C/ Julian Clavería 8, 33006, Oviedo. Spain.
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14
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Nakae S, Kumon M, Murayama K, Ohba S, Sasaki H, Inamasu J, Kuwahara K, Yamada S, Abe M, Hirose Y. Association of preoperative seizures with tumor metabolites quantified by magnetic resonance spectroscopy in gliomas. Sci Rep 2021; 11:7927. [PMID: 33846339 PMCID: PMC8041994 DOI: 10.1038/s41598-021-86487-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/16/2021] [Indexed: 02/02/2023] Open
Abstract
Seizures are common in patients with gliomas; however, the mechanisms of epileptogenesis in gliomas have not been fully understood. This study hypothesized that analyzing quantified metabolites using magnetic resonance spectroscopy (MRS) might provide novel insights to better understand the epileptogenesis in gliomas, and specific metabolites might be indicators of preoperative seizures in gliomas. We retrospectively investigated patient information (gender, age at diagnosis of tumor, their survival time) and tumor information (location, histology, genetic features, and metabolites according to MRS) in patients with gliomas. The data were correlated with the incidence of seizure and analyzed statistically. Of 146 adult supratentorial gliomas, isocitrate dehydrogenase (IDH) mutant tumors significantly indicated higher incidence of preoperative seizures than IDH wild-type gliomas. However, MRS study indicated that glutamate concentration in IDH wild-type gliomas was higher than that in IDH mutant gliomas. Glutamate was not associated with high frequency of preoperative seizures in patients with gliomas. Instead, increased total N-acetyl-L-aspartate (tNAA) was significantly associated with them. Moreover, multivariable analysis indicated that increased level of tNAA was an independent predictor of preoperative seizures. According to MRS analysis, tNAA, rather than glutamate, might be a useful to detect preoperative seizures in patient with supratentorial gliomas.
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Affiliation(s)
- Shunsuke Nakae
- Department of Neurosurgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.
| | - Masanobu Kumon
- Department of Neurosurgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Kazuhiro Murayama
- Department of Radiology, Fujita Health University, Toyoake, Aichi, Japan
| | - Shigeo Ohba
- Department of Neurosurgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Hikaru Sasaki
- Department of Neurosurgery, Keio University, Tokyo, Japan
| | - Joji Inamasu
- Department of Neurosurgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Kiyonori Kuwahara
- Department of Neurosurgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Seiji Yamada
- Department of Pathology, Fujita Health University, Toyoake, Aichi, Japan
| | - Masato Abe
- Department of Pathology, Fujita Health University, Toyoake, Aichi, Japan
| | - Yuichi Hirose
- Department of Neurosurgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
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15
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Radoul M, Hong D, Gillespie AM, Najac C, Viswanath P, Pieper RO, Costello JF, Luchman HA, Ronen SM. Early Noninvasive Metabolic Biomarkers of Mutant IDH Inhibition in Glioma. Metabolites 2021; 11:metabo11020109. [PMID: 33668509 PMCID: PMC7917625 DOI: 10.3390/metabo11020109] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 12/17/2022] Open
Abstract
Approximately 80% of low-grade glioma (LGGs) harbor mutant isocitrate dehydrogenase 1/2 (IDH1/2) driver mutations leading to accumulation of the oncometabolite 2-hydroxyglutarate (2-HG). Thus, inhibition of mutant IDH is considered a potential therapeutic target. Several mutant IDH inhibitors are currently in clinical trials, including AG-881 and BAY-1436032. However, to date, early detection of response remains a challenge. In this study we used high resolution 1H magnetic resonance spectroscopy (1H-MRS) to identify early noninvasive MR (Magnetic Resonance)-detectable metabolic biomarkers of response to mutant IDH inhibition. In vivo 1H-MRS was performed on mice orthotopically-implanted with either genetically engineered (U87IDHmut) or patient-derived (BT257 and SF10417) mutant IDH1 cells. Treatment with either AG-881 or BAY-1436032 induced a significant reduction in 2-HG. Moreover, both inhibitors led to a significant early and sustained increase in glutamate and the sum of glutamate and glutamine (GLX) in all three models. A transient early increase in N-acetylaspartate (NAA) was also observed. Importantly, all models demonstrated enhanced animal survival following both treatments and the metabolic alterations were observed prior to any detectable differences in tumor volume between control and treated tumors. Our study therefore identifies potential translatable early metabolic biomarkers of drug delivery, mutant IDH inhibition and glioma response to treatment with emerging clinically relevant therapies.
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Affiliation(s)
- Marina Radoul
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94158, USA; (M.R.); (D.H.); (A.M.G.); (C.N.); (P.V.)
| | - Donghyun Hong
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94158, USA; (M.R.); (D.H.); (A.M.G.); (C.N.); (P.V.)
| | - Anne Marie Gillespie
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94158, USA; (M.R.); (D.H.); (A.M.G.); (C.N.); (P.V.)
| | - Chloé Najac
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94158, USA; (M.R.); (D.H.); (A.M.G.); (C.N.); (P.V.)
| | - Pavithra Viswanath
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94158, USA; (M.R.); (D.H.); (A.M.G.); (C.N.); (P.V.)
| | - Russell O. Pieper
- Department of Neurological Surgery, Helen Diller Research Center, University of California, San Francisco, CA 94158, USA; (R.O.P.); (J.F.C.)
- Brain Tumor Research Center, University of California, San Francisco, CA 94158, USA
| | - Joseph F. Costello
- Department of Neurological Surgery, Helen Diller Research Center, University of California, San Francisco, CA 94158, USA; (R.O.P.); (J.F.C.)
| | - Hema Artee Luchman
- Arnie Charbonneau Cancer Institute and Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 4N1, Canada;
| | - Sabrina M. Ronen
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94158, USA; (M.R.); (D.H.); (A.M.G.); (C.N.); (P.V.)
- Brain Tumor Research Center, University of California, San Francisco, CA 94158, USA
- Correspondence: ; Tel.: +1-415-514-4839
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16
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Ruiz-Rodado V, Brender JR, Cherukuri MK, Gilbert MR, Larion M. Magnetic resonance spectroscopy for the study of cns malignancies. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2021; 122:23-41. [PMID: 33632416 PMCID: PMC7910526 DOI: 10.1016/j.pnmrs.2020.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 11/20/2020] [Accepted: 11/22/2020] [Indexed: 05/04/2023]
Abstract
Despite intensive research, brain tumors are amongst the malignancies with the worst prognosis; therefore, a prompt diagnosis and thoughtful assessment of the disease is required. The resistance of brain tumors to most forms of conventional therapy has led researchers to explore the underlying biology in search of new vulnerabilities and biomarkers. The unique metabolism of brain tumors represents one potential vulnerability and the basis for a system of classification. Profiling this aberrant metabolism requires a method to accurately measure and report differences in metabolite concentrations. Magnetic resonance-based techniques provide a framework for examining tumor tissue and the evolution of disease. Nuclear Magnetic Resonance (NMR) analysis of biofluids collected from patients suffering from brain cancer can provide biological information about disease status. In particular, urine and plasma can serve to monitor the evolution of disease through the changes observed in the metabolic profiles. Moreover, cerebrospinal fluid can be utilized as a direct reporter of cerebral activity since it carries the chemicals exchanged with the brain tissue and the tumor mass. Metabolic reprogramming has recently been included as one of the hallmarks of cancer. Accordingly, the metabolic rewiring experienced by these tumors to sustain rapid growth and proliferation can also serve as a potential therapeutic target. The combination of 13C tracing approaches with the utilization of different NMR spectral modalities has allowed investigations of the upregulation of glycolysis in the aggressive forms of brain tumors, including glioblastomas, and the discovery of the utilization of acetate as an alternative cellular fuel in brain metastasis and gliomas. One of the major contributions of magnetic resonance to the assessment of brain tumors has been the non-invasive determination of 2-hydroxyglutarate (2HG) in tumors harboring a mutation in isocitrate dehydrogenase 1 (IDH1). The mutational status of this enzyme already serves as a key feature in the clinical classification of brain neoplasia in routine clinical practice and pilot studies have established the use of in vivo magnetic resonance spectroscopy (MRS) for monitoring disease progression and treatment response in IDH mutant gliomas. However, the development of bespoke methods for 2HG detection by MRS has been required, and this has prevented the wider implementation of MRS methodology into the clinic. One of the main challenges for improving the management of the disease is to obtain an accurate insight into the response to treatment, so that the patient can be promptly diverted into a new therapy if resistant or maintained on the original therapy if responsive. The implementation of 13C hyperpolarized magnetic resonance spectroscopic imaging (MRSI) has allowed detection of changes in tumor metabolism associated with a treatment, and as such has been revealed as a remarkable tool for monitoring response to therapeutic strategies. In summary, the application of magnetic resonance-based methodologies to the diagnosis and management of brain tumor patients, in addition to its utilization in the investigation of its tumor-associated metabolic rewiring, is helping to unravel the biological basis of malignancies of the central nervous system.
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Affiliation(s)
- Victor Ruiz-Rodado
- Neuro-Oncology Branch, National Cancer Institute, Center for Cancer Research, National Institute of Health, Bethesda, United States.
| | - Jeffery R Brender
- Radiation Biology Branch, Center for Cancer Research, National Institute of Health, Bethesda, United States
| | - Murali K Cherukuri
- Radiation Biology Branch, Center for Cancer Research, National Institute of Health, Bethesda, United States
| | - Mark R Gilbert
- Neuro-Oncology Branch, National Cancer Institute, Center for Cancer Research, National Institute of Health, Bethesda, United States
| | - Mioara Larion
- Neuro-Oncology Branch, National Cancer Institute, Center for Cancer Research, National Institute of Health, Bethesda, United States.
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17
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Pascale RM, Calvisi DF, Simile MM, Feo CF, Feo F. The Warburg Effect 97 Years after Its Discovery. Cancers (Basel) 2020; 12:E2819. [PMID: 33008042 PMCID: PMC7599761 DOI: 10.3390/cancers12102819] [Citation(s) in RCA: 153] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 09/22/2020] [Indexed: 02/06/2023] Open
Abstract
The deregulation of the oxidative metabolism in cancer, as shown by the increased aerobic glycolysis and impaired oxidative phosphorylation (Warburg effect), is coordinated by genetic changes leading to the activation of oncogenes and the loss of oncosuppressor genes. The understanding of the metabolic deregulation of cancer cells is necessary to prevent and cure cancer. In this review, we illustrate and comment the principal metabolic and molecular variations of cancer cells, involved in their anomalous behavior, that include modifications of oxidative metabolism, the activation of oncogenes that promote glycolysis and a decrease of oxygen consumption in cancer cells, the genetic susceptibility to cancer, the molecular correlations involved in the metabolic deregulation in cancer, the defective cancer mitochondria, the relationships between the Warburg effect and tumor therapy, and recent studies that reevaluate the Warburg effect. Taken together, these observations indicate that the Warburg effect is an epiphenomenon of the transformation process essential for the development of malignancy.
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Affiliation(s)
- Rosa Maria Pascale
- Department of Medical, Surgery and Experimental Sciences, Division of Experimental Pathology and Oncology, University of Sassari, 07100 Sassari, Italy; (D.F.C.); (M.M.S.); (F.F.)
| | - Diego Francesco Calvisi
- Department of Medical, Surgery and Experimental Sciences, Division of Experimental Pathology and Oncology, University of Sassari, 07100 Sassari, Italy; (D.F.C.); (M.M.S.); (F.F.)
| | - Maria Maddalena Simile
- Department of Medical, Surgery and Experimental Sciences, Division of Experimental Pathology and Oncology, University of Sassari, 07100 Sassari, Italy; (D.F.C.); (M.M.S.); (F.F.)
| | - Claudio Francesco Feo
- Department of Clinical, Surgery and Experimental Sciences, Division of Surgery, University of Sassari, 07100 Sassari, Italy;
| | - Francesco Feo
- Department of Medical, Surgery and Experimental Sciences, Division of Experimental Pathology and Oncology, University of Sassari, 07100 Sassari, Italy; (D.F.C.); (M.M.S.); (F.F.)
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18
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Nguyen TB, Melkus G, Taccone M, Moldovan ID, Ghinda D, Gotfrit R, Torres CH, Zakhari N, Chakraborty S, Woulfe J, Jansen G, McInnes MD, Thornhill RE, Cameron I, AlKherayf F. Preoperative Determination of Isocitrate Dehydrogenase Mutation in Gliomas Using Spectral Editing MRS: A Prospective Study. J Magn Reson Imaging 2020; 53:416-426. [PMID: 32940938 DOI: 10.1002/jmri.27366] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/22/2020] [Accepted: 08/27/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The edited magnetic resonance spectroscopy (MRS) technique has not yet been formally evaluated for the in vivo detection of 2-hydroxyglutarate (2-HG) in patients with gliomas of various grades. PURPOSE To evaluate the diagnostic accuracy of edited MRS in the preoperative identification of the isocitrate dehydrogenase (IDH) mutation status in patients with gliomas. STUDY TYPE Prospective. POPULATION Fifty-eight subjects (31 glioblastomas, 27 grade II and III gliomas). FIELD STRENGTH/SEQUENCE Mescher-Garwood (MEGA)-PRESS and routine clinical brain tumor MR sequences were used at 3T. ASSESSMENT Data were analyzed using an advanced method for accurate, robust, and efficient spectral fitting (AMARES) from jMRUI software. The amplitudes of the 2-HG, N-acetyl-aspartate (NAA), choline (Cho), and creatine/phosphocreatine (Cr) resonances were calculated with their associated Cramer-Rao lower bound (CRLB). The IDH1 R132H mutation status was assessed by immunohistochemistry for all patients. Patients with grades II and III gliomas with negative immunohistochemistry underwent DNA sequencing to further interrogate IDH mutation status. STATISTICAL TEST The differences in 2-HG amplitudes, 2-HG/NAA, 2-HG/Cho, and 2-HG/Cr between IDH-mutant and IDH-wildtype gliomas were assessed using Mann-Whitney U-tests. Receiver operating characteristic curve analysis was performed to evaluate the diagnostic accuracy of each parameter. RESULTS The 2-HG amplitudes, 2-HG/NAA, and 2-HG/Cho were higher for IDH-mutant gliomas than IDH-wildtype gliomas (P < 0.007). Using a CRLB threshold <30%, a 2-HG cutoff greater than 0 had a sensitivity of 80% (95% confidence interval [CI]: 52-96%) and a specificity of 81% (95% CI: 54-96%) in identifying IDH-mutant gliomas. In the subset of patients with grades II and III gliomas, the sensitivity was 80% (95% CI: 52-96%) and specificity was 100% (95% CI: 40-100%). Among 2-HG ratios, the highest AUC for the identification of IDH mutant status was achieved using the 2-HG/NAA (AUC = 0.8, 95% CI 0.67-.89). DATA CONCLUSION Preoperative edited MRS appears to be able to help identify IDH-mutant gliomas with high specificity. Level of Evidence 1 Technical Efficacy Stage 2 J. MAGN. RESON. IMAGING 2021;53:416-426.
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Affiliation(s)
- Thanh B Nguyen
- Department of Radiology, The Ottawa Hospital, Ottawa, Ontario, Canada.,University of Ottawa, Ottawa, Ontario, Canada.,The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Gerd Melkus
- Department of Radiology, The Ottawa Hospital, Ottawa, Ontario, Canada.,University of Ottawa, Ottawa, Ontario, Canada.,The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Michael Taccone
- University of Ottawa, Ottawa, Ontario, Canada.,Division of Neurosurgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Ioana D Moldovan
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Division of Neurosurgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Diana Ghinda
- University of Ottawa, Ottawa, Ontario, Canada.,Division of Neurosurgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Ryan Gotfrit
- University of Ottawa, Ottawa, Ontario, Canada.,Division of Neurology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Carlos H Torres
- Department of Radiology, The Ottawa Hospital, Ottawa, Ontario, Canada.,University of Ottawa, Ottawa, Ontario, Canada
| | - Nader Zakhari
- Department of Radiology, The Ottawa Hospital, Ottawa, Ontario, Canada.,University of Ottawa, Ottawa, Ontario, Canada
| | - Santanu Chakraborty
- Department of Radiology, The Ottawa Hospital, Ottawa, Ontario, Canada.,University of Ottawa, Ottawa, Ontario, Canada
| | - John Woulfe
- University of Ottawa, Ottawa, Ontario, Canada.,The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Gerard Jansen
- University of Ottawa, Ottawa, Ontario, Canada.,Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Matthew Df McInnes
- Department of Radiology, The Ottawa Hospital, Ottawa, Ontario, Canada.,University of Ottawa, Ottawa, Ontario, Canada.,The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Rebecca E Thornhill
- Department of Radiology, The Ottawa Hospital, Ottawa, Ontario, Canada.,University of Ottawa, Ottawa, Ontario, Canada
| | - Ian Cameron
- Department of Radiology, The Ottawa Hospital, Ottawa, Ontario, Canada.,University of Ottawa, Ottawa, Ontario, Canada
| | - Fahad AlKherayf
- University of Ottawa, Ottawa, Ontario, Canada.,The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Division of Neurosurgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada
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19
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Liu Y, Lang F, Chou FJ, Zaghloul KA, Yang C. Isocitrate Dehydrogenase Mutations in Glioma: Genetics, Biochemistry, and Clinical Indications. Biomedicines 2020; 8:biomedicines8090294. [PMID: 32825279 PMCID: PMC7554955 DOI: 10.3390/biomedicines8090294] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 12/22/2022] Open
Abstract
Mutations in isocitrate dehydrogenase (IDH) are commonly observed in lower-grade glioma and secondary glioblastomas. IDH mutants confer a neomorphic enzyme activity that converts α-ketoglutarate to an oncometabolite D-2-hydroxyglutarate, which impacts cellular epigenetics and metabolism. IDH mutation establishes distinctive patterns in metabolism, cancer biology, and the therapeutic sensitivity of glioma. Thus, a deeper understanding of the roles of IDH mutations is of great value to improve the therapeutic efficacy of glioma and other malignancies that share similar genetic characteristics. In this review, we focused on the genetics, biochemistry, and clinical impacts of IDH mutations in glioma.
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Affiliation(s)
- Yang Liu
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892, USA; (Y.L.); (F.L.); (F.-J.C.)
| | - Fengchao Lang
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892, USA; (Y.L.); (F.L.); (F.-J.C.)
| | - Fu-Ju Chou
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892, USA; (Y.L.); (F.L.); (F.-J.C.)
| | - Kareem A. Zaghloul
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Chunzhang Yang
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892, USA; (Y.L.); (F.L.); (F.-J.C.)
- Correspondence: ; Tel.: +1-240-760-7083
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20
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Branzoli F, Marjańska M. Magnetic resonance spectroscopy of isocitrate dehydrogenase mutated gliomas: current knowledge on the neurochemical profile. Curr Opin Neurol 2020; 33:413-421. [PMID: 32657882 PMCID: PMC7526653 DOI: 10.1097/wco.0000000000000833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Magnetic resonance spectroscopy (MRS) may play a key role for the management of patients with glioma. We highlighted the utility of MRS in the noninvasive diagnosis of gliomas with mutations in isocitrate dehydrogenase (IDH) genes, by providing an overview of the neurochemical alterations observed in different glioma subtypes, as well as during treatment and progression, both in vivo and ex vivo. RECENT FINDINGS D-2-hydroxyglutarate (2HG) decrease during anticancer treatments was recently shown to be associated with altered levels of other metabolites, including lactate, glutamate and glutathione, suggesting that tumour treatment leads to a metabolic reprogramming beyond 2HG depletion. In combination with 2HG quantification, cystathionine and glycine seem to be the most promising candidates for higher specific identification of glioma subtypes and follow-up of disease progression and response to treatment. SUMMARY The implementation of advanced MRS methods in the routine clinical practice will allow the quantification of metabolites that are not detectable with conventional methods and may enable immediate, accurate diagnosis of gliomas, which is crucial for planning optimal therapeutic strategies and follow-up examinations. The role of different metabolites as predictors of patient outcome still needs to be elucidated.
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Affiliation(s)
- Francesca Branzoli
- Institut du Cerveau - ICM, Centre de Neuroimagerie de Recherche - CENIR
- ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, Paris, France
| | - Małgorzata Marjańska
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
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21
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Molloy AR, Najac C, Viswanath P, Lakhani A, Subramani E, Batsios G, Radoul M, Gillespie AM, Pieper RO, Ronen SM. MR-detectable metabolic biomarkers of response to mutant IDH inhibition in low-grade glioma. Theranostics 2020; 10:8757-8770. [PMID: 32754276 PMCID: PMC7392019 DOI: 10.7150/thno.47317] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/17/2020] [Indexed: 12/14/2022] Open
Abstract
Mutations in isocitrate dehydrogenase 1 (IDH1mut) are reported in 70-90% of low-grade gliomas and secondary glioblastomas. IDH1mut catalyzes the reduction of α-ketoglutarate (α-KG) to 2-hydroxyglutarate (2-HG), an oncometabolite which drives tumorigenesis. Inhibition of IDH1mut is therefore an emerging therapeutic approach, and inhibitors such as AG-120 and AG-881 have shown promising results in phase 1 and 2 clinical studies. However, detection of response to these therapies prior to changes in tumor growth can be challenging. The goal of this study was to identify non-invasive clinically translatable metabolic imaging biomarkers of IDH1mut inhibition that can serve to assess response. Methods: IDH1mut inhibition was confirmed using an enzyme assay and 1H- and 13C- magnetic resonance spectroscopy (MRS) were used to investigate the metabolic effects of AG-120 and AG-881 on two genetically engineered IDH1mut-expressing cell lines, NHAIDH1mut and U87IDH1mut. Results:1H-MRS indicated a significant decrease in steady-state 2-HG following treatment, as expected. This was accompanied by a significant 1H-MRS-detectable increase in glutamate. However, other metabolites previously linked to 2-HG were not altered. 13C-MRS also showed that the steady-state changes in glutamate were associated with a modulation in the flux of glutamine to both glutamate and 2-HG. Finally, hyperpolarized 13C-MRS was used to show that the flux of α-KG to both glutamate and 2-HG was modulated by treatment. Conclusion: In this study, we identified potential 1H- and 13C-MRS-detectable biomarkers of response to IDH1mut inhibition in gliomas. Although further studies are needed to evaluate the utility of these biomarkers in vivo, we expect that in addition to a 1H-MRS-detectable drop in 2-HG, a 1H-MRS-detectable increase in glutamate, as well as a hyperpolarized 13C-MRS-detectable change in [1-13C] α-KG flux, could serve as metabolic imaging biomarkers of response to treatment.
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Affiliation(s)
- Abigail R Molloy
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Chloé Najac
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Pavithra Viswanath
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Aliya Lakhani
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Elavarasan Subramani
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Georgios Batsios
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Marina Radoul
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Anne Marie Gillespie
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Russell O Pieper
- Brain Tumor Center, University of California San Francisco, San Francisco, CA, USA
- Department of Neurological Surgery, Helen Diller Research Center, University of California San Francisco, San Francisco, CA, USA
| | - Sabrina M Ronen
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
- Brain Tumor Center, University of California San Francisco, San Francisco, CA, USA
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22
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Tiwari V, Daoud EV, Hatanpaa KJ, Gao A, Zhang S, An Z, Ganji SK, Raisanen JM, Lewis CM, Askari P, Baxter J, Levy M, Dimitrov I, Thomas BP, Pinho MC, Madden CJ, Pan E, Patel TR, DeBerardinis RJ, Sherry AD, Mickey BE, Malloy CR, Maher EA, Choi C. Glycine by MR spectroscopy is an imaging biomarker of glioma aggressiveness. Neuro Oncol 2020; 22:1018-1029. [PMID: 32055850 PMCID: PMC7339885 DOI: 10.1093/neuonc/noaa034] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND High-grade gliomas likely remodel the metabolic machinery to meet the increased demands for amino acids and nucleotides during rapid cell proliferation. Glycine, a non-essential amino acid and intermediate of nucleotide biosynthesis, may increase with proliferation. Non-invasive measurement of glycine by magnetic resonance spectroscopy (MRS) was evaluated as an imaging biomarker for assessment of tumor aggressiveness. METHODS We measured glycine, 2-hydroxyglutarate (2HG), and other tumor-related metabolites in 35 glioma patients using an MRS sequence tailored for co-detection of glycine and 2HG in gadolinium-enhancing and non-enhancing tumor regions on 3T MRI. Glycine and 2HG concentrations as measured by MRS were correlated with tumor cell proliferation (MIB-1 labeling index), expression of mitochondrial serine hydroxymethyltransferase (SHMT2), and glycine decarboxylase (GLDC) enzymes, and patient overall survival. RESULTS Elevated glycine was strongly associated with presence of gadolinium enhancement, indicating more rapidly proliferative disease. Glycine concentration was positively correlated with MIB-1, and levels higher than 2.5 mM showed significant association with shorter patient survival, irrespective of isocitrate dehydrogenase status. Concentration of 2HG did not correlate with MIB-1 index. A high glycine/2HG concentration ratio, >2.5, was strongly associated with shorter survival (P < 0.0001). GLDC and SHMT2 expression were detectable in all tumors with glycine concentration, demonstrating an inverse correlation with GLDC. CONCLUSIONS The data suggest that aggressive gliomas reprogram glycine-mediated one-carbon metabolism to meet the biosynthetic demands for rapid cell proliferation. MRS evaluation of glycine provides a non-invasive metabolic imaging biomarker that is predictive of tumor progression and clinical outcome. KEY POINTS 1. Glycine and 2-hydroxyglutarate in glioma patients are precisely co-detected using MRS at 3T.2. Tumors with elevated glycine proliferate and progress rapidly.3. A high glycine/2HG ratio is predictive of shortened patient survival.
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Affiliation(s)
- Vivek Tiwari
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Elena V Daoud
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Kimmo J Hatanpaa
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas
- Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
- Annette Strauss Center for Neuro-Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ang Gao
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Song Zhang
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Zhongxu An
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Sandeep K Ganji
- Philips Healthcare, Andover, Massachusetts
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jack M Raisanen
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas
- Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
- Annette Strauss Center for Neuro-Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Cheryl M Lewis
- Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Pegah Askari
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jeannie Baxter
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Michael Levy
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ivan Dimitrov
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
- Philips Medical Systems, Cleveland, Ohio
| | - Binu P Thomas
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Marco C Pinho
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Christopher J Madden
- Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
- Annette Strauss Center for Neuro-Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Edward Pan
- Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Toral R Patel
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ralph J DeBerardinis
- Howard Hughes Medical Institute, University of Texas Southwestern Medical Center, Dallas, Texas
- Children’s Research Institute, University of Texas Southwestern Medical Center, Dallas, Texas
- McDermott Center for Human Growth and Development, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas
| | - A Dean Sherry
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Chemistry, University of Texas at Dallas, Dallas, Texas
| | - Bruce E Mickey
- Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
- Annette Strauss Center for Neuro-Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Craig R Malloy
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
- Veterans Affairs North Texas Health Care System, Dallas, Texas
| | - Elizabeth A Maher
- Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
- Annette Strauss Center for Neuro-Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Changho Choi
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
- Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
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23
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Barekatain Y, Yan VC, Arthur K, Ackroyd JJ, Khadka S, De Groot J, Huse JT, Muller FL. Robust detection of oncometabolic aberrations by 1H- 13C heteronuclear single quantum correlation in intact biological specimens. Commun Biol 2020; 3:328. [PMID: 32587392 PMCID: PMC7316726 DOI: 10.1038/s42003-020-1055-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 05/29/2020] [Indexed: 01/02/2023] Open
Abstract
Magnetic resonance (MR) spectroscopy has potential to non-invasively detect metabolites of diagnostic significance for precision oncology. Yet, many metabolites have similar chemical shifts, yielding highly convoluted 1H spectra of intact biological material and limiting diagnostic utility. Here, we show that hydrogen–carbon heteronuclear single quantum correlation (1H–13C HSQC) offers dramatic improvements in sensitivity compared to one-dimensional (1D) 13C NMR and significant signal deconvolution compared to 1D 1H spectra in intact biological settings. Using a standard NMR spectroscope with a cryoprobe but without specialized signal enhancing features such as magic angle spinning, metabolite extractions or 13C-isotopic enrichment, we obtain well-resolved 2D 1H–13C HSQC spectra in live cancer cells, in ex vivo freshly dissected xenografted tumors and resected primary tumors. This method can identify tumors with specific oncometabolite alterations such as IDH mutations by 2-hydroxyglutarate and PGD-deleted tumors by gluconate. Results suggest potential of 1H–13C HSQC as a non-invasive diagnostic in precision oncology. Barekatain et al. demonstrate that hydrogen–carbon heteronuclear single quantum correlation (HSQC) spectra, obtained using a standard NMR spectroscope, can detect tumours with specific oncometabolite alterations including IDH1 mutant glioblastoma, suggesting the feasibility of this method as a diagnostic tool.
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Affiliation(s)
- Yasaman Barekatain
- Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, 77054, USA
| | - Victoria C Yan
- Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, 77054, USA
| | - Kenisha Arthur
- Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, 77054, USA
| | - Jeffrey J Ackroyd
- Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, 77054, USA
| | - Sunada Khadka
- Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, 77054, USA
| | - John De Groot
- Department of Neuro-Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Jason T Huse
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Florian L Muller
- Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, 77054, USA.
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24
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Fujita Y, Kohta M, Sasayama T, Tanaka K, Hashiguchi M, Nagashima H, Kyotani K, Nakai T, Ito T, Kohmura E. Intraoperative 3-T Magnetic Resonance Spectroscopy for Detection of Proliferative Remnants of Glioma. World Neurosurg 2020; 137:149-157. [PMID: 32035198 DOI: 10.1016/j.wneu.2020.01.217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 01/28/2020] [Accepted: 01/28/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND Few studies have examined the usefulness of intraoperative magnetic resonance spectroscopy (iMRS) for identifying abnormal signals at the resection margin during glioma surgery. The aim of this study was to assess the value of iMRS for detecting proliferative remnants of glioma at the resection margin. METHODS Fifteen patients with newly diagnosed glioma underwent single-voxel 3-T iMRS concurrently with intraoperative magnetic resonance imaging-assisted surgery. Volumes of interest (VOIs) were placed at T2-hyperintense or contrast-enhancing lesions at the resection margin. In addition to technical verification, the correlation between the MIB-1 labeling index (a pathologic feature) and metabolites measured using iMRS (N-acetyl-L-aspartate [NAA], choline [Cho], and Cho/NAA ratio) was analyzed. RESULTS iMRS was performed for 20 VOIs in 15 patients. Fourteen (70%) of these VOIs were confirmed to be MIB-1-positive. There was a significant positive correlation between the Cho/NAA ratio and MIB-1 index (r = 0.46, P = 0.04). Cho level (P = 0.003) and Cho/NAA ratio (P = 0.002) were significantly higher in VOIs that were MIB-1-positive than in those that were MIB-1-negative. Detection of a Cho level >1.074 mM and a Cho/NAA ratio >0.48 using iMRS resulted in high diagnostic accuracy for MIB-1-positive remnants (Cho level: sensitivity 86%, specificity 100%; Cho/NAA ratio: sensitivity 79%, specificity 100%). CONCLUSIONS This study provides evidence that 3-T iMRS can detect proliferative remnants of glioma at the resection margin using the Cho level and Cho/NAA ratio, suggesting that intraoperative magnetic resonance imaging-assisted surgery with iMRS would be practicable in glioma.
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Affiliation(s)
- Yuichi Fujita
- Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Masaaki Kohta
- Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
| | - Takashi Sasayama
- Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Kazuhiro Tanaka
- Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Mitsuru Hashiguchi
- Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Hiroaki Nagashima
- Department of Neurosurgery, Massachusetts General Hospital Research Institute, Boston, Massachusetts, USA
| | - Katsusuke Kyotani
- Center for Radiology and Radiation Oncology, Kobe University Graduate School of Medicine and Kobe University Hospital, Kobe, Hyogo, Japan
| | - Tomoaki Nakai
- Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Tomoo Ito
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Eiji Kohmura
- Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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25
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Tiwari V, Mashimo T, An Z, Vemireddy V, Piccirillo S, Askari P, Hulsey KM, Zhang S, de Graaf RA, Patel TR, Pan E, Mickey BE, Maher EA, Bachoo RM, Choi C. In vivo MRS measurement of 2-hydroxyglutarate in patient-derived IDH-mutant xenograft mouse models versus glioma patients. Magn Reson Med 2020; 84:1152-1160. [PMID: 32003035 DOI: 10.1002/mrm.28183] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 12/09/2019] [Accepted: 01/03/2020] [Indexed: 11/10/2022]
Abstract
PURPOSE To generate a preclinical model of isocitrate dehydrogenase (IDH) mutant gliomas from glioma patients and design a MRS method to test the compatibility of 2-hydroxyglutarate (2HG) production between the preclinical model and patients. METHODS Five patient-derived xenograft (PDX) mice were generated from two glioma patients with IDH1 R132H mutation. A PRESS sequence was tailored at 9.4 T, with computer simulation and phantom analyses, for improving 2HG detection in mice. 2HG and other metabolites in the PDX mice were measured using the optimized MRS at 9.4 T and compared with 3 T MRS measurements of the metabolites in the parental-tumor patients. Spectral fitting was performed with LCModel using in-house basis spectra. Metabolite levels were quantified with reference to water. RESULTS The PRESS TE was optimized to be 96 ms, at which the 2HG 2.25 ppm signal was narrow and inverted, thereby leading to unequivocal separation of the 2HG resonance from adjacent signals from other metabolites. The optimized MRS provided precise detection of 2HG in mice compared to short-TE MRS at 9.4 T. The 2HG estimates in PDX mice were in excellent agreement with the 2HG measurements in the patients. CONCLUSION The similarity of 2HG production between PDX models and parental-tumor patients indicates that PDX tumors retain the parental IDH metabolic fingerprint and can serve as a preclinical model for improving our understanding of the IDH-mutation associated metabolic reprogramming.
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Affiliation(s)
- Vivek Tiwari
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Tomoyuki Mashimo
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.,Annette G. Strauss Center for Neuro-Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Zhongxu An
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Vamsidhara Vemireddy
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Sara Piccirillo
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Pegah Askari
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas.,Joint Graduate Program in Biomedical Engineering at University of Texas Arlington and University of Texas Southwestern Medical Center, Texas
| | - Keith M Hulsey
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Shanrong Zhang
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Robin A de Graaf
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut.,Department of Biomedical Engineering, Yale University School of Medicine, New Haven, Connecticut
| | - Toral R Patel
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Edward Pan
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas.,Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Bruce E Mickey
- Annette G. Strauss Center for Neuro-Oncology, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.,Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Elizabeth A Maher
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.,Annette G. Strauss Center for Neuro-Oncology, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas.,Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Robert M Bachoo
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.,Annette G. Strauss Center for Neuro-Oncology, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas.,Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Changho Choi
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas.,Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
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Kirov II, Tal A. Potential clinical impact of multiparametric quantitative MR spectroscopy in neurological disorders: A review and analysis. Magn Reson Med 2020; 83:22-44. [PMID: 31393032 PMCID: PMC6814297 DOI: 10.1002/mrm.27912] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 06/06/2019] [Accepted: 06/29/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE Unlike conventional MR spectroscopy (MRS), which only measures metabolite concentrations, multiparametric MRS also quantifies their longitudinal (T1 ) and transverse (T2 ) relaxation times, as well as the radiofrequency transmitter inhomogeneity (B1+ ). To test whether knowledge of these additional parameters can improve the clinical utility of brain MRS, we compare the conventional and multiparametric approaches in terms of expected classification accuracy in differentiating controls from patients with neurological disorders. THEORY AND METHODS A literature review was conducted to compile metabolic concentrations and relaxation times in a wide range of neuropathologies and regions of interest. Simulations were performed to construct receiver operating characteristic curves and compute the associated areas (area under the curve) to examine the sensitivity and specificity of MRS for detecting each pathology in each region. Classification accuracy was assessed using metabolite concentrations corrected using population-averages for T1 , T2 , and B1+ (conventional MRS); using metabolite concentrations corrected using per-subject values (multiparametric MRS); and using an optimal linear multiparametric estimator comprised of the metabolites' concentrations and relaxation constants (multiparametric MRS). Additional simulations were conducted to find the minimal intra-subject precision needed for each parameter. RESULTS Compared with conventional MRS, multiparametric approaches yielded area under the curve improvements for almost all neuropathologies and regions of interest. The median area under the curve increased by 0.14 over the entire dataset, and by 0.24 over the 10 instances with the largest individual increases. CONCLUSIONS Multiparametric MRS can substantially improve the clinical utility of MRS in diagnosing and assessing brain pathology, motivating the design and use of novel multiparametric sequences.
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Affiliation(s)
- Ivan I. Kirov
- Center for Advanced Imaging Innovation and Research (CAIR), Bernard and Irene Schwartz Center for Biomedical Imaging, New York University School of Medicine, Department of Radiology, 660 1 Avenue, New York, NY 10016, United States of America
| | - Assaf Tal
- Department of Chemical and Biological Physics, Weizmann Institute of Science, 234 Herzel St., Rehovot 7610001, Israel
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Magnetic Resonance Spectroscopic Assessment of Isocitrate Dehydrogenase Status in Gliomas: The New Frontiers of Spectrobiopsy in Neurodiagnostics. World Neurosurg 2020; 133:e421-e427. [DOI: 10.1016/j.wneu.2019.09.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 09/06/2019] [Indexed: 12/21/2022]
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Thalamic GABA may modulate cognitive control in restless legs syndrome. Neurosci Lett 2019; 712:134494. [DOI: 10.1016/j.neulet.2019.134494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 09/03/2019] [Accepted: 09/10/2019] [Indexed: 11/18/2022]
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Ozturk-Isik E, Cengiz S, Ozcan A, Yakicier C, Ersen Danyeli A, Pamir MN, Özduman K, Dincer A. Identification of IDH and TERTp mutation status using 1 H-MRS in 112 hemispheric diffuse gliomas. J Magn Reson Imaging 2019; 51:1799-1809. [PMID: 31664773 DOI: 10.1002/jmri.26964] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/22/2019] [Accepted: 09/24/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND There is a growing interest in noninvasively defining molecular subsets of hemispheric diffuse gliomas based on the isocitrate dehydrogenase (IDH) and telomerase reverse transcriptase gene promoter (TERTp) mutation status, which correspond to distinct tumor entities, and differ in demographics, natural history, treatment response, recurrence, and survival patterns. PURPOSE To investigate whether metabolite levels detected with short echo time (TE) proton MR spectroscopy (1 H-MRS) at 3T can be used for noninvasive molecular classification of IDH and TERTp mutation-based subsets of gliomas. STUDY TYPE Retrospective. SUBJECTS In all, 112 hemispheric diffuse gliomas (70 males/42 females, mean age: 42.1 ± 13.9 years). FIELD STRENGTH/SEQUENCE Short-TE 1 H-MRS (repetition time (TR) = 2000 msec, TE = 30 msec, number of signal averages = 192) and routine clinical brain tumor MR protocols were acquired at 3T. ASSESSMENT 1 H-MRS data were quantified using LCModel software. TERTp and IDH1 or IDH2 (IDH1/2) mutations in the tissue were determined by either minisequencing or Sanger sequencing. STATISTICAL TESTS Metabolic differences between IDH mutant and IDH wildtype gliomas were assessed by a Mann-Whitney U-test. A Kruskal-Wallis test followed by a Tukey-Kramer test was used to analyze metabolic differences between IDH and TERTp mutational molecular subsets of gliomas. A Spearman rank correlation coefficient was used to assess the correlations of metabolite intensities with the Ki-67 index. Furthermore, machine learning was employed to classify the IDH and TERTp mutational status of gliomas, and the accuracy, sensitivity, and specificity values were estimated. RESULTS Short-TE 1 H-MRS classified the presence of an IDH mutation with 88.39% accuracy, 76.92% sensitivity, and 94.52% specificity, and a TERTp mutation within primary IDH wildtype gliomas with 92.59% accuracy, 83.33% sensitivity, and 95.24% specificity. DATA CONCLUSION Short-TE 1 H-MRS could be used to identify molecular subsets of hemispheric diffuse gliomas corresponding to IDH and TERTp mutations. LEVEL OF EVIDENCE 3 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2020;51:1799-1809.
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Affiliation(s)
- Esin Ozturk-Isik
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey.,Brain Tumor Research Group, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Sevim Cengiz
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey
| | - Alpay Ozcan
- Brain Tumor Research Group, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.,Department of Medical Device Technologies, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.,Biomedical Imaging Research and Development Center, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.,Center for Neuroradiological Applications and Research, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Cengiz Yakicier
- Department of Molecular Biology and Genetics, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Ayca Ersen Danyeli
- Brain Tumor Research Group, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.,Department of Pathology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - M Necmettin Pamir
- Brain Tumor Research Group, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.,Department of Neurosurgery, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.,Center for Neuroradiological Applications and Research, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Koray Özduman
- Brain Tumor Research Group, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.,Department of Neurosurgery, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.,Center for Neuroradiological Applications and Research, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Alp Dincer
- Brain Tumor Research Group, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.,Department of Radiology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.,Center for Neuroradiological Applications and Research, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
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30
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In vivo 2-hydroxyglutarate-proton magnetic resonance spectroscopy (3 T, PRESS technique) in treatment-naïve suspect lower-grade gliomas: feasibility and accuracy in a clinical setting. Neurol Sci 2019; 41:347-355. [PMID: 31650436 DOI: 10.1007/s10072-019-04087-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Accepted: 09/24/2019] [Indexed: 12/11/2022]
Abstract
Isocitrate dehydrogenase 1/2 (IDH1/2) mutations are often detected in lower-grade gliomas (LGG) and result into 2-hydroxyglutarate (2HG) synthesis. Prior studies showed that 2HG can be detected in vivo using magnetic resonance spectroscopy (MRS), but its accuracy and translational impact are still under investigation. PURPOSE To investigate the clinical feasibility of MRS for in vivo detection and quantification of 2HG on consecutive treatment-naïve suspect LGG patients and to compare MRS accuracy with tissue IDH1/2 analysis. METHODS MRS spectra at 3 T were acquired with 1H-MRS single-voxel PRESS 2HG-tailored sequences with TE 30 (group 1) or TE 97 (groups 2A and B). Voxel sizes were 1.5 × 1.5 × 1.5 cm3 for group 1 (n = 13) and group 2A (n = 14) and 2 × 2 × 2 cm3 for group 2B (n = 32). Multiple metabolites' concentrations were analyzed with LCModel. Tumors were assessed for IDH status and main molecular markers. 2HG levels in urine/blood were measured by liquid chromatography-mass spectrometry. RESULTS The larger voxel TE 97 sequence resulted in highest specificity (100%), sensitivity (79%), and accuracy (87%). Urine and blood 2HG did not result predictive. CONCLUSION Our data confirm that 2 × 2 × 2-cm3 voxel TE 97 MRS shows high accuracy for 2HG detection, with good sensitivity and 100% specificity in distinguishing IDH mutant gliomas. Main limits of the technique are small tumor volume and low cellularity. Integrating 2HG-MRS with other metabolites may help non-invasive diagnosis of glioma, prognostic assessment, and treatment planning in clinical setting.
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Zhou M, Zhou Y, Liao H, Rowland BC, Kong X, Arvold ND, Reardon DA, Wen PY, Lin AP, Huang RY. Diagnostic accuracy of 2-hydroxyglutarate magnetic resonance spectroscopy in newly diagnosed brain mass and suspected recurrent gliomas. Neuro Oncol 2019; 20:1262-1271. [PMID: 29438510 DOI: 10.1093/neuonc/noy022] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Isocitrate dehydrogenase (IDH) mutations result in abnormal accumulation of 2-hydroxyglutarate (2HG) in gliomas that can be detected by MRS. We examined the diagnostic accuracy of 2HG single-voxel spectroscopy (SVS) and chemical shift imaging (CSI) in both newly diagnosed and posttreatment settings. Methods Long echo time (97 ms) SVS and CSI were acquired in 85 subjects, including a discovery cohort of 39 patients who had postoperative residual or recurrent glioma with confirmed IDH-mutation status and 6 normal volunteers, a prospective preoperative validation cohort of 24 patients with newly diagnosed brain mass, and a prospective recurrent-lesion validation cohort of 16 previously treated IDH-mutant glioma patients with suspected tumor recurrence. The optimal thresholds for both methods in diagnosing IDH status were determined by receiver operating characteristic analysis in the discovery cohort and then applied to the 2 validation cohorts to assess the diagnostic performance. Results The optimal 2HG/creatine thresholds of SVS and 75th percentile CSI for IDH mutations were 0.11 and 0.23, respectively. When applied to the validation sets, the sensitivity, specificity, and accuracy in distinguishing IDH-mutant gliomas in the preoperative cohort were 85.71%, 100.00%, and 94.12% for SVS, and 100.00%, 69.23%, and 81.82% for CSI, respectively. In the recurrent-lesion cohort, the sensitivity, specificity, and accuracy for discriminating IDH-positive recurrent gliomas were 40.00%, 62.50%, and 53.85% for SVS, and 66.67%, 100.00%, and 86.67% for CSI, respectively. Conclusions 2HG MRS provides diagnostic utility for IDH-mutant gliomas both preoperatively and at time of suspected tumor recurrence. SVS has a better diagnostic performance for untreated IDH-mutant gliomas, whereas CSI demonstrates greater performance in identifying recurrent tumors.
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Affiliation(s)
- Min Zhou
- Center for Clinical Spectroscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yue Zhou
- Center for Clinical Spectroscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Huijun Liao
- Center for Clinical Spectroscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Benjamin C Rowland
- Center for Clinical Spectroscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Xiangquan Kong
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Nils D Arvold
- St Luke's Radiation Oncology Associates, St Luke's Regional Cancer Center, and Whiteside Institute for Clinical Research/University of Minnesota Duluth, Duluth, Minnesota, USA
| | - David A Reardon
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Patrick Y Wen
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Alexander P Lin
- Center for Clinical Spectroscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Raymond Y Huang
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical College, Boston, Massachusetts, USA
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Suh CH, Kim HS, Jung SC, Choi CG, Kim SJ. 2-Hydroxyglutarate MR spectroscopy for prediction of isocitrate dehydrogenase mutant glioma: a systemic review and meta-analysis using individual patient data. Neuro Oncol 2019; 20:1573-1583. [PMID: 30020513 DOI: 10.1093/neuonc/noy113] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 07/11/2018] [Indexed: 12/31/2022] Open
Abstract
Background Noninvasive and accurate modality to predict isocitrate dehydrogenase (IDH) mutant glioma may have great potential in routine clinical practice. We aimed to investigate the diagnostic performance of 2-hydroxyglutarate (2HG) magnetic resonance spectroscopy (MRS) for prediction of IDH mutant glioma and provide an optimal cutoff value for 2HG. Methods A systematic literature search of Ovid-MEDLINE and EMBASE was performed to identify original articles investigating the diagnostic performance of 2HG MRS up to March 20, 2018. Pooled sensitivity and specificity were calculated using a bivariate random-effects model. Subgroup analysis and meta-regression were performed to explain heterogeneity effects. An optimal cutoff value for 2HG was calculated from studies providing individual patient data. Results Fourteen original articles with 460 patients were included. The pooled sensitivity and specificity for the diagnostic performance of 2HG MRS for prediction of IDH mutant glioma were 95% (95% CI, 85-98%) and 91% (95% CI, 83-96%), respectively. The Higgins I2 statistic demonstrated that heterogeneity was present in the sensitivity (I2 = 50.69%), but not in the specificity (I2 = 30.37%). In the meta-regression, echo time (TE) was associated with study heterogeneity. Among the studies using point-resolved spectroscopy (PRESS), a long TE (97 ms) resulted in higher sensitivity (92%) and specificity (97%) than a short TE (30-35 ms; sensitivity of 90%, specificity of 88%; P < 0.01). The optimal 2HG cutoff value of 2HG using individual patient data was 1.76 mM. Conclusion 2HG MRS demonstrated excellent specificity for prediction of IDH mutant glioma, with TE being associated with heterogeneity in the sensitivity. Key Points 1. HG MRS has excellent diagnostic performance in the prediction of IDH mutant glioma. 2. The pooled sensitivity was 95% and the pooled specificity was 91%. 3. Echo time was associated with study heterogeneity in the meta-regression.
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Affiliation(s)
- Chong Hyun Suh
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Ho Sung Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Seung Chai Jung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Choong Gon Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Sang Joon Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Nalawade S, Murugesan GK, Vejdani-Jahromi M, Fisicaro RA, Bangalore Yogananda CG, Wagner B, Mickey B, Maher E, Pinho MC, Fei B, Madhuranthakam AJ, Maldjian JA. Classification of brain tumor isocitrate dehydrogenase status using MRI and deep learning. J Med Imaging (Bellingham) 2019; 6:046003. [PMID: 31824982 PMCID: PMC6903425 DOI: 10.1117/1.jmi.6.4.046003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 11/18/2019] [Indexed: 11/14/2022] Open
Abstract
Isocitrate dehydrogenase (IDH) mutation status is an important marker in glioma diagnosis and therapy. We propose an automated pipeline for noninvasively predicting IDH status using deep learning and T2-weighted (T2w) magnetic resonance (MR) images with minimal preprocessing (N4 bias correction and normalization to zero mean and unit variance). T2w MR images and genomic data were obtained from The Cancer Imaging Archive dataset for 260 subjects (120 high-grade and 140 low-grade gliomas). A fully automated two-dimensional densely connected model was trained to classify IDH mutation status on 208 subjects and tested on another held-out set of 52 subjects using fivefold cross validation. Data leakage was avoided by ensuring subject separation during the slice-wise randomization. Mean classification accuracy of 90.5% was achieved for each axial slice in predicting the three classes of no tumor, IDH mutated, and IDH wild type. Test accuracy of 83.8% was achieved in predicting IDH mutation status for individual subjects on the test dataset of 52 subjects. We demonstrate a deep learning method to predict IDH mutation status using T2w MRI alone. Radiologic imaging studies using deep learning methods must address data leakage (subject duplication) in the randomization process to avoid upward bias in the reported classification accuracy.
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Affiliation(s)
- Sahil Nalawade
- UT Southwestern Medical Center, Department of Radiology, Dallas, Texas, United States
| | - Gowtham K. Murugesan
- UT Southwestern Medical Center, Department of Radiology, Dallas, Texas, United States
| | | | - Ryan A. Fisicaro
- UT Southwestern Medical Center, Department of Radiology, Dallas, Texas, United States
| | | | - Ben Wagner
- UT Southwestern Medical Center, Department of Radiology, Dallas, Texas, United States
| | - Bruce Mickey
- UT Southwestern Medical Center, Department of Neurological Surgery, Dallas, Texas, United States
| | - Elizabeth Maher
- UT Southwestern Medical Center, Department of Neurology and Neurotherapeutics, Dallas, Texas, United States
| | - Marco C. Pinho
- UT Southwestern Medical Center, Department of Radiology, Dallas, Texas, United States
| | - Baowei Fei
- UT Southwestern Medical Center, Department of Radiology, Dallas, Texas, United States
- UT Dallas, Department of Bioengineering, Richardson, Texas, United States
| | | | - Joseph A. Maldjian
- UT Southwestern Medical Center, Department of Radiology, Dallas, Texas, United States
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Suh CH, Kim HS, Paik W, Choi C, Ryu KH, Kim D, Woo DC, Park JE, Jung SC, Choi CG, Kim SJ. False-Positive Measurement at 2-Hydroxyglutarate MR Spectroscopy in Isocitrate Dehydrogenase Wild-Type Glioblastoma: A Multifactorial Analysis. Radiology 2019; 291:752-762. [PMID: 30990380 DOI: 10.1148/radiol.2019182200] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Isocitrate dehydrogenase (IDH) mutation has become one of the most important prognostic biomarkers in glioma management. Measurement of 2-hydroxyglutarate (2HG) with MR spectroscopy has shown high pooled sensitivity, although false-positive results with MR spectroscopy have been reported. Purpose To investigate factors associated with false-positive 2HG measurements at MR spectroscopy in patients with IDH wild-type glioblastoma. Materials and Methods This retrospective study was approved by the institutional review board, and informed consent was waived. Consecutive patients with histopathologically confirmed pre- and posttreatment glioblastoma were evaluated between December 2017 and August 2018. Spectroscopy parameters, including 2HG measurements, were obtained with single-voxel point-resolved spectroscopy, and apparent diffusion coefficient (ADC) values were calculated. Necrosis was graded according to the proportion of necrosis within a volume of interest. Poisson regression analyses were performed to determine factors related to false-positive 2HG measurements. Results A total of 82 patients were included (mean age, 55 years ± 12 [standard deviation]; 40 men). The 2HG measurement showed a false-positive rate of 21% (17 of 82; 95% CI: 13%, 31%) in patients with IDH wild-type glioblastoma. Multivariable analysis revealed that necrosis (prevalence ratio [PR], 3.9; 95% CI: 1.6, 9.4; P = .01) and ADC value (PR, 0.1 × 10-3 mm2/sec; 95% CI: [0.0, 0.7] × 10-3 mm2/sec; P = .02) were associated with a greater false-positive rate for the 2HG measurement. Necrosis of more than 20% was associated with a higher rate of false-positive 2HG measurements (50%) than was necrosis of 20% or less (15%, P = .01). The 2HG false-positive rate was higher in patients with pretreatment glioblastoma (46%) than in those with posttreatment glioblastoma (14%, P < .01). Among 17 patients with false-positive findings, 15 (88%; 95% CI: 64%, 99%) had a lactate concentration of 2.0 mmol/L or higher, and 14 (82%, 95% CI: 57%, 96%) had a lactate concentration of 3.0 mmol/L or higher. Conclusion Necrosis and apparent diffusion coefficient were associated with false-positive measurements of 2-hydroxyglutarate at MR spectroscopy in patients with isocitrate dehydrogenase wild-type glioblastoma. © RSNA, 2019 Online supplemental material is available for this article.
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Affiliation(s)
- Chong Hyun Suh
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul 05505, Republic of Korea (C.H.S., H.S.K., D.K., J.E.P., S.C.J., C.G.C., S.J.K.); Department of Radiology, Gangneung Asan Hospital, Gangneung, Republic of Korea (W.P.); Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Tex (C.C.); Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea (K.H.R.); and Bioimaging Center, Biomedical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea (D.C.W.)
| | - Ho Sung Kim
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul 05505, Republic of Korea (C.H.S., H.S.K., D.K., J.E.P., S.C.J., C.G.C., S.J.K.); Department of Radiology, Gangneung Asan Hospital, Gangneung, Republic of Korea (W.P.); Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Tex (C.C.); Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea (K.H.R.); and Bioimaging Center, Biomedical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea (D.C.W.)
| | - Wooyul Paik
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul 05505, Republic of Korea (C.H.S., H.S.K., D.K., J.E.P., S.C.J., C.G.C., S.J.K.); Department of Radiology, Gangneung Asan Hospital, Gangneung, Republic of Korea (W.P.); Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Tex (C.C.); Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea (K.H.R.); and Bioimaging Center, Biomedical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea (D.C.W.)
| | - Changho Choi
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul 05505, Republic of Korea (C.H.S., H.S.K., D.K., J.E.P., S.C.J., C.G.C., S.J.K.); Department of Radiology, Gangneung Asan Hospital, Gangneung, Republic of Korea (W.P.); Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Tex (C.C.); Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea (K.H.R.); and Bioimaging Center, Biomedical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea (D.C.W.)
| | - Kyeong Hwa Ryu
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul 05505, Republic of Korea (C.H.S., H.S.K., D.K., J.E.P., S.C.J., C.G.C., S.J.K.); Department of Radiology, Gangneung Asan Hospital, Gangneung, Republic of Korea (W.P.); Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Tex (C.C.); Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea (K.H.R.); and Bioimaging Center, Biomedical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea (D.C.W.)
| | - Donghyun Kim
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul 05505, Republic of Korea (C.H.S., H.S.K., D.K., J.E.P., S.C.J., C.G.C., S.J.K.); Department of Radiology, Gangneung Asan Hospital, Gangneung, Republic of Korea (W.P.); Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Tex (C.C.); Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea (K.H.R.); and Bioimaging Center, Biomedical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea (D.C.W.)
| | - Dong-Cheol Woo
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul 05505, Republic of Korea (C.H.S., H.S.K., D.K., J.E.P., S.C.J., C.G.C., S.J.K.); Department of Radiology, Gangneung Asan Hospital, Gangneung, Republic of Korea (W.P.); Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Tex (C.C.); Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea (K.H.R.); and Bioimaging Center, Biomedical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea (D.C.W.)
| | - Ji Eun Park
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul 05505, Republic of Korea (C.H.S., H.S.K., D.K., J.E.P., S.C.J., C.G.C., S.J.K.); Department of Radiology, Gangneung Asan Hospital, Gangneung, Republic of Korea (W.P.); Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Tex (C.C.); Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea (K.H.R.); and Bioimaging Center, Biomedical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea (D.C.W.)
| | - Seung Chai Jung
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul 05505, Republic of Korea (C.H.S., H.S.K., D.K., J.E.P., S.C.J., C.G.C., S.J.K.); Department of Radiology, Gangneung Asan Hospital, Gangneung, Republic of Korea (W.P.); Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Tex (C.C.); Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea (K.H.R.); and Bioimaging Center, Biomedical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea (D.C.W.)
| | - Choong Gon Choi
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul 05505, Republic of Korea (C.H.S., H.S.K., D.K., J.E.P., S.C.J., C.G.C., S.J.K.); Department of Radiology, Gangneung Asan Hospital, Gangneung, Republic of Korea (W.P.); Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Tex (C.C.); Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea (K.H.R.); and Bioimaging Center, Biomedical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea (D.C.W.)
| | - Sang Joon Kim
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul 05505, Republic of Korea (C.H.S., H.S.K., D.K., J.E.P., S.C.J., C.G.C., S.J.K.); Department of Radiology, Gangneung Asan Hospital, Gangneung, Republic of Korea (W.P.); Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Tex (C.C.); Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea (K.H.R.); and Bioimaging Center, Biomedical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea (D.C.W.)
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Wenger KJ, Hattingen E, Harter PN, Richter C, Franz K, Steinbach JP, Bähr O, Pilatus U. Fitting algorithms and baseline correction influence the results of non-invasive in vivo quantitation of 2-hydroxyglutarate with 1 H-MRS. NMR IN BIOMEDICINE 2019; 32:e4027. [PMID: 30457203 DOI: 10.1002/nbm.4027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 09/11/2018] [Accepted: 09/12/2018] [Indexed: 06/09/2023]
Abstract
1 H-MRS enables non-invasive detection of 2-hydroxyglutarate (2-HG), an oncometabolite accumulating in gliomas carrying mutations in the isocitrate dehydrogenase (IDH) genes. Reliable 2-HG quantitation requires reproducible post-processing, deployment of fitting algorithms and quantitation methods. We prospectively enrolled 38 patients with suspected or recently diagnosed gliomas (IDH mutated n = 26). The MRI protocol included a 1 H single voxel PRESS sequence with volumes of usually 8 mL or more (20 × 20 × 20 mm3 ) at TE = 97 ms and 180° pulse spacing. Our aim was to evaluate the reliability of 2-HG quantitation comparing two frequently used software tools and their respective options of baseline correction (jMRUI with the time domain methods AQSES and QUEST, and LCModel, which analyzes the frequency domain data). For AQSES, degrees of freedom for baseline correction constrains were varied. For LCModel, baseline correction was obtained with and without correction of the unknown background term (predefined macromolecules, lipids). Tissue concentrations were calculated based on the phantom replacement method. Quantitation of 2-HG levels showed similar mean 2-HG tissue concentrations for IDH mutated tumors (2.65mM, range 3.06-2.20) for all methods. Bland-Altman plots (difference plots) did not reveal a systematic bias (fixed bias) for any of the algorithms tested, and we were able to show a significant correlation regarding 2-HG concentration at the same echo time with few statistical outliers (parametric correlation). However, evaluation of outliers suggested that in vivo quantitation of 2-HG is affected not only by the fitting domain (time or frequency), but also by the baseline correction, which is a major contributing factor to the result of 2-HG fitting. Clinical application of 2-HG quantitation as a prognostic or predictive biomarker, particularly in multicenter trials, requires standardized use of fitting methods and baseline correction procedures.
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Affiliation(s)
- Katharina J Wenger
- Klinikum der Johann Wolfgang Goethe-Universitat Frankfurt, Senckenberg Institute of Neurooncology, Frankfurt, Germany
| | - Elke Hattingen
- Universitatsklinikum Bonn, Institute of Neuroradiology, Bonn, Germany
| | - Patrick N Harter
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt, Edinger Institute, Neuropathology, Frankfurt, Germany
| | - Christian Richter
- Goethe Universität Frankfurt am Main, Organic Chemistry, Schwalbe Group, Frankfurt, Germany
| | - Kea Franz
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt, Institute of Neurosurgery, Frankfurt, Germany
| | - Joachim P Steinbach
- Klinikum der Johann Wolfgang Goethe-Universitat Frankfurt, Senckenberg Institute of Neurooncology, Frankfurt, Germany
| | - Oliver Bähr
- Klinikum der Johann Wolfgang Goethe-Universitat Frankfurt, Senckenberg Institute of Neurooncology, Frankfurt, Germany
| | - Ulrich Pilatus
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt, Institute of Neuroradiology, Frankfurt, Germany
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36
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Cruzat V, Macedo Rogero M, Noel Keane K, Curi R, Newsholme P. Glutamine: Metabolism and Immune Function, Supplementation and Clinical Translation. Nutrients 2018; 10:nu10111564. [PMID: 30360490 PMCID: PMC6266414 DOI: 10.3390/nu10111564] [Citation(s) in RCA: 545] [Impact Index Per Article: 90.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 10/13/2018] [Accepted: 10/16/2018] [Indexed: 02/07/2023] Open
Abstract
Glutamine is the most abundant and versatile amino acid in the body. In health and disease, the rate of glutamine consumption by immune cells is similar or greater than glucose. For instance, in vitro and in vivo studies have determined that glutamine is an essential nutrient for lymphocyte proliferation and cytokine production, macrophage phagocytic plus secretory activities, and neutrophil bacterial killing. Glutamine release to the circulation and availability is mainly controlled by key metabolic organs, such as the gut, liver, and skeletal muscles. During catabolic/hypercatabolic situations glutamine can become essential for metabolic function, but its availability may be compromised due to the impairment of homeostasis in the inter-tissue metabolism of amino acids. For this reason, glutamine is currently part of clinical nutrition supplementation protocols and/or recommended for immune suppressed individuals. However, in a wide range of catabolic/hypercatabolic situations (e.g., ill/critically ill, post-trauma, sepsis, exhausted athletes), it is currently difficult to determine whether glutamine supplementation (oral/enteral or parenteral) should be recommended based on the amino acid plasma/bloodstream concentration (also known as glutaminemia). Although the beneficial immune-based effects of glutamine supplementation are already established, many questions and evidence for positive in vivo outcomes still remain to be presented. Therefore, this paper provides an integrated review of how glutamine metabolism in key organs is important to cells of the immune system. We also discuss glutamine metabolism and action, and important issues related to the effects of glutamine supplementation in catabolic situations.
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Affiliation(s)
- Vinicius Cruzat
- School of Pharmacy and Biomedical Sciences, Curtin Health Innovation Research Institute, Biosciences, Curtin University, Perth 6102, Australia.
- Faculty of Health, Torrens University, Melbourne 3065, Australia.
| | - Marcelo Macedo Rogero
- Department of Nutrition, Faculty of Public Health, University of São Paulo, Avenida Doutor Arnaldo 715, São Paulo 01246-904, Brazil.
| | - Kevin Noel Keane
- School of Pharmacy and Biomedical Sciences, Curtin Health Innovation Research Institute, Biosciences, Curtin University, Perth 6102, Australia.
| | - Rui Curi
- Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo 01506-000, Brazil.
| | - Philip Newsholme
- School of Pharmacy and Biomedical Sciences, Curtin Health Innovation Research Institute, Biosciences, Curtin University, Perth 6102, Australia.
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Cruzat V, Macedo Rogero M, Noel Keane K, Curi R, Newsholme P. Glutamine: Metabolism and Immune Function, Supplementation and Clinical Translation. Nutrients 2018. [PMID: 30360490 DOI: 10.20944/preprints201809.0459.v1] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Glutamine is the most abundant and versatile amino acid in the body. In health and disease, the rate of glutamine consumption by immune cells is similar or greater than glucose. For instance, in vitro and in vivo studies have determined that glutamine is an essential nutrient for lymphocyte proliferation and cytokine production, macrophage phagocytic plus secretory activities, and neutrophil bacterial killing. Glutamine release to the circulation and availability is mainly controlled by key metabolic organs, such as the gut, liver, and skeletal muscles. During catabolic/hypercatabolic situations glutamine can become essential for metabolic function, but its availability may be compromised due to the impairment of homeostasis in the inter-tissue metabolism of amino acids. For this reason, glutamine is currently part of clinical nutrition supplementation protocols and/or recommended for immune suppressed individuals. However, in a wide range of catabolic/hypercatabolic situations (e.g., ill/critically ill, post-trauma, sepsis, exhausted athletes), it is currently difficult to determine whether glutamine supplementation (oral/enteral or parenteral) should be recommended based on the amino acid plasma/bloodstream concentration (also known as glutaminemia). Although the beneficial immune-based effects of glutamine supplementation are already established, many questions and evidence for positive in vivo outcomes still remain to be presented. Therefore, this paper provides an integrated review of how glutamine metabolism in key organs is important to cells of the immune system. We also discuss glutamine metabolism and action, and important issues related to the effects of glutamine supplementation in catabolic situations.
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Affiliation(s)
- Vinicius Cruzat
- School of Pharmacy and Biomedical Sciences, Curtin Health Innovation Research Institute, Biosciences, Curtin University, Perth 6102, Australia. .,Faculty of Health, Torrens University, Melbourne 3065, Australia.
| | - Marcelo Macedo Rogero
- Department of Nutrition, Faculty of Public Health, University of São Paulo, Avenida Doutor Arnaldo 715, São Paulo 01246-904, Brazil.
| | - Kevin Noel Keane
- School of Pharmacy and Biomedical Sciences, Curtin Health Innovation Research Institute, Biosciences, Curtin University, Perth 6102, Australia.
| | - Rui Curi
- Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo 01506-000, Brazil.
| | - Philip Newsholme
- School of Pharmacy and Biomedical Sciences, Curtin Health Innovation Research Institute, Biosciences, Curtin University, Perth 6102, Australia.
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Abstract
INTRODUCTION The kidney-type glutaminase (GLS) controlling the first step of glutamine metabolism is overexpressed in many cancer cells. Targeting inhibition of GLS shows obvious inhibitory effects on cancer cell proliferation. Therefore, extensive research and development of GLS inhibitors have been carried out in industrial and academic institutions over the past decade to address this unmet medical need. AREAS COVERED This review covers researches and patent literatures in the field of discovery and development of small molecule inhibitors of GLS for cancer therapy over the past 16 years. EXPERT OPINION The detailed ligand-receptor interaction information from their complex structure not only guides the rational drug design, but also facilitates in silico structure-based virtual ligand screening of novel GLS inhibitors. Multi-drug combination administration is of great significance both in terms of safety and efficacy.
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Affiliation(s)
- CanRong Wu
- a Hubei Key Laboratory of Natural Medicinal Chemistry and Resource Evaluation, School of Pharmacy, Tongji Medical College , Huazhong University of Science and Technology , Wuhan , China
| | - LiXia Chen
- b Wuya College of Innovation, Key Laboratory of Structure-Based Drug Design and Discovery, Ministry of Education , Shenyang Pharmaceutical University , Shenyang , China
| | - Sanshan Jin
- c Maternal and Child Health Hospital of Hubei Province , Wuhan , China
| | - Hua Li
- a Hubei Key Laboratory of Natural Medicinal Chemistry and Resource Evaluation, School of Pharmacy, Tongji Medical College , Huazhong University of Science and Technology , Wuhan , China.,b Wuya College of Innovation, Key Laboratory of Structure-Based Drug Design and Discovery, Ministry of Education , Shenyang Pharmaceutical University , Shenyang , China
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Carlin D, Babourina-Brooks B, Davies NP, Wilson M, Peet AC. Variation of T 2 relaxation times in pediatric brain tumors and their effect on metabolite quantification. J Magn Reson Imaging 2018; 49:195-203. [PMID: 29697883 PMCID: PMC6492201 DOI: 10.1002/jmri.26054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/29/2018] [Accepted: 03/29/2018] [Indexed: 12/24/2022] Open
Abstract
Background Metabolite concentrations are fundamental biomarkers of disease and prognosis. Magnetic resonance spectroscopy (MRS) is a noninvasive method for measuring metabolite concentrations; however, quantitation is affected by T2 relaxation. Purpose To estimate T2 relaxation times in pediatric brain tumors and assess how variation in T2 relaxation affects metabolite quantification. Study Type Retrospective. Population Twenty‐seven pediatric brain tumor patients (n = 17 pilocytic astrocytoma and n = 10 medulloblastoma) and 24 age‐matched normal controls. Field Strength/Sequence Short‐ (30 msec) and long‐echo (135 msec) single‐voxel MRS acquired at 1.5T. Assessment T2 relaxation times were estimated by fitting signal amplitudes at two echo times to a monoexponential decay function and were used to correct metabolite concentration estimates for relaxation effects. Statistical Tests One‐way analysis of variance (ANOVA) on ranks were used to analyze the mean T2 relaxation times and metabolite concentrations for each tissue group and paired Mann–Whitney U‐tests were performed. Results The mean T2 relaxation of water was measured as 181 msec, 123 msec, 90 msec, and 86 msec in pilocytic astrocytomas, medulloblastomas, basal ganglia, and white matter, respectively. The T2 of water was significantly longer in both tumor groups than normal brain (P < 0.001) and in pilocytic astrocytomas compared with medulloblastomas (P < 0.01). The choline T2 relaxation time was significantly longer in medulloblastomas compared with pilocytic astrocytomas (P < 0.05), while the T2 relaxation time of NAA was significantly shorter in pilocytic astrocytomas compared with normal brain (P < 0.001). Overall, the metabolite concentrations were underestimated by ∼22% when default T2 values were used compared with case‐specific T2 values at short echo time. The difference was reduced to 4% when individually measured water T2s were used. Data Conclusion Differences exist in water and metabolite T2 relaxation times for pediatric brain tumors, which lead to significant underestimation of metabolite concentrations when using default water T2 relaxation times. Level of Evidence: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:195–203.
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Affiliation(s)
- Dominic Carlin
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, West Midlands, UK.,Birmingham Children's Hospital NHS Foundation Trust, Birmingham, West Midlands, UK
| | - Ben Babourina-Brooks
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, West Midlands, UK.,Birmingham Children's Hospital NHS Foundation Trust, Birmingham, West Midlands, UK
| | - Nigel P Davies
- Birmingham Children's Hospital NHS Foundation Trust, Birmingham, West Midlands, UK.,Imaging and Medical Physics, University Hospitals Birmingham NHS Foundation Trust, Birmingham, West Midlands, UK
| | - Martin Wilson
- Birmingham Children's Hospital NHS Foundation Trust, Birmingham, West Midlands, UK.,Birmingham University Imaging Centre (BUIC), School of Psychology, University of Birmingham, West Midlands, UK
| | - Andrew C Peet
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, West Midlands, UK.,Birmingham Children's Hospital NHS Foundation Trust, Birmingham, West Midlands, UK
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Berrington A, Voets NL, Larkin SJ, de Pennington N, Mccullagh J, Stacey R, Schofield CJ, Jezzard P, Clare S, Cadoux-Hudson T, Plaha P, Ansorge O, Emir UE. A comparison of 2-hydroxyglutarate detection at 3 and 7 T with long-TE semi-LASER. NMR IN BIOMEDICINE 2018; 31. [PMID: 29315915 DOI: 10.1002/nbm.3886] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 06/07/2023]
Abstract
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 3 T, 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 (≥7 T) 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 = 110 ms) is a promising method for improved 2-HG detection in vivo at either 3 or 7 T owing to the use of broad-band adiabatic localization. Using previously published semi-LASER methods at 3 and 7 T, this study directly compares the detectability of 2-HG in phantoms and in vivo across nine patients. Cramér-Rao lower bounds (CRLBs) of 2-HG fitting were found to be significantly lower at 7 T (6 ± 2%) relative to 3 T (15 ± 7%) (p = 0.0019), yet were larger at 7 T in an IDH wild-type patient. Although no increase in SNR was detected at 7 T (77 ± 26) relative to 3 T (77 ± 30), the detection of 2-HG was greatly enhanced through an improved spectral profile and increased resolution at 7 T. 7 T had a large effect on pairwise fitting correlations between γ-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 7 T 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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Affiliation(s)
- Adam Berrington
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Natalie L Voets
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Sarah J Larkin
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Nick de Pennington
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Department of Neurosurgery, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | | | - Richard Stacey
- Department of Neurosurgery, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | | | - Peter Jezzard
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Stuart Clare
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Tom Cadoux-Hudson
- Department of Neurosurgery, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Puneet Plaha
- Department of Neurosurgery, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Olaf Ansorge
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Uzay E Emir
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
- School of Health Sciences, Purdue University, West Lafayette, IN, USA
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Tiwari V, An Z, Wang Y, Choi C. Distinction of the GABA 2.29 ppm resonance using triple refocusing at 3 T in vivo. Magn Reson Med 2018; 80:1307-1319. [PMID: 29446149 DOI: 10.1002/mrm.27142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 01/29/2018] [Accepted: 01/30/2018] [Indexed: 12/21/2022]
Abstract
PURPOSE To develop 1 H MR spectroscopy that provides distinction of γ-aminobutyric acid (GABA) signal at 3 T in vivo. METHODS Triple-refocusing was tailored at 3 T, with numerical simulations and phantom validation, for distinction of the GABA 2.29-ppm resonance from the neighboring glutamate resonance. The optimization was performed on the inter-RF pulse time delays and the duration and carrier frequency of a non-slice-selective RF pulse. The optimized triple refocusing was tested in multiple regions in 6 healthy subjects, including hippocampus. The in vivo spectra were analyzed with the LCModel using in-house basis spectra. After normalization of the metabolite signal estimates to water, the metabolite concentrations were quantified with reference to medial-occipital creatine at 8 mM. RESULTS A triple-refocusing scheme with optimized inter-RF pulse time delays (TE = 74 ms) was obtained for GABA detection. With optimized duration (14 ms) and carrier frequency (4.5 ppm) of the non-slice-selective RF pulse, the triple refocusing gave rise to distinction between the GABA 2.29-ppm and glutamate 2.35-ppm signals. The GABA 2.29-ppm signal was clearly discernible in spectra in vivo (voxel size 4 to 12 mL; scan times 4.3 to 17 minutes). With a total of 24 spectra from 6 gray or white matter-dominant regions, the GABA concentration was measured to be 0.62 to 1.15 mM (Cramer-Rao lower bound of 8 to 14%), and the glutamate level 5.8 to 11.2 mM (Cramer-Rao lower bound of 3 to 6%). CONCLUSION The optimized triple refocusing provided distinction between GABA and glutamate signals and permitted direct codetection of these metabolites in the human brain at 3 T in vivo.
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Affiliation(s)
- Vivek Tiwari
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Zhongxu An
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Yiming Wang
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Changho Choi
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
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2-Hydroxyglutarate Detection by Short Echo Time Magnetic Resonance Spectroscopy in Routine Imaging Study of Brain Glioma at 3.0 T. J Comput Assist Tomogr 2018; 42:469-474. [DOI: 10.1097/rct.0000000000000705] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Discriminating MGMT promoter methylation status in patients with glioblastoma employing amide proton transfer-weighted MRI metrics. Eur Radiol 2017; 28:2115-2123. [PMID: 29234914 DOI: 10.1007/s00330-017-5182-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/30/2017] [Accepted: 11/06/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To explore the feasibility of using amide proton transfer-weighted (APTw) MRI metrics as surrogate biomarkers to identify the O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation status in glioblastoma (GBM). METHODS Eighteen newly diagnosed GBM patients, who were previously scanned at 3T and had a confirmed MGMT methylation status, were retrospectively analysed. For each case, a histogram analysis in the tumour mass was performed to evaluate several quantitative APTw MRI metrics. The Mann-Whitney test was used to evaluate the difference in APTw parameters between MGMT methylated and unmethylated GBMs, and the receiver-operator-characteristic analysis was further used to assess diagnostic performance. RESULTS Ten GBMs were found to harbour a methylated MGMT promoter, and eight GBMs were unmethylated. The mean, variance, 50th percentile, 90th percentile and Width10-90 APTw values were significantly higher in the MGMT unmethylated GBMs than in the MGMT methylated GBMs, with areas under the receiver-operator-characteristic curves of 0.825, 0.837, 0.850, 0856 and 0.763, respectively, for the discrimination of MGMT promoter methylation status. CONCLUSIONS APTw signal metrics have the potential to serve as valuable imaging biomarkers for identifying MGMT methylation status in the GBM population. KEY POINTS • APTw-MRI is applied to predict MGMT promoter methylation status in GBMs. • GBMs with unmethylated MGMT promoter present higher APTw-MRI than methylated GBMs. • Multiple APTw histogram metrics can identify MGMT methylation status. • Mean APTw values showed the highest diagnostic accuracy (AUC = 0.825).
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Reliable diagnosis of IDH-mutant glioblastoma by 2-hydroxyglutarate detection: a study by 3-T magnetic resonance spectroscopy. Neurosurg Rev 2017; 41:641-647. [DOI: 10.1007/s10143-017-0908-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 08/25/2017] [Accepted: 09/15/2017] [Indexed: 12/18/2022]
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An Z, Tiwari V, Ganji SK, Baxter J, Levy M, Pinho MC, Pan E, Maher EA, Patel TR, Mickey BE, Choi C. Echo-planar spectroscopic imaging with dual-readout alternated gradients (DRAG-EPSI) at 7 T: Application for 2-hydroxyglutarate imaging in glioma patients. Magn Reson Med 2017; 79:1851-1861. [PMID: 28833542 DOI: 10.1002/mrm.26884] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 07/13/2017] [Accepted: 07/31/2017] [Indexed: 11/10/2022]
Abstract
PURPOSE To develop echo-planar spectroscopic imaging (EPSI) with large spectral width and accomplish high-resolution imaging of 2-hydroxyglutarate (2HG) at 7 T. METHODS We designed a new EPSI readout scheme at 7 T. Data were recorded with dual-readout alternated gradients and combined according to the gradient polarity. Following validation of its performance in phantoms, the new readout scheme, together with previously reported 2HG-optimized magnetic resonance spectroscopy (point-resolved spectroscopy echo time of 78 ms), was used for time-efficient and high-resolution imaging of 2HG and other metabolites in five glioma patients before treatment. Unsuppressed water, acquired with EPSI, was used as reference for multichannel combination, eddy-current compensation, and metabolite quantification. Spectral fitting was conducted with the LCModel using in-house calculated basis sets. RESULTS Using a readout gradient strength of 9.5 mT/m and slew rate of 90 mT/m/ms, dual-readout alternated gradients EPSI permitted 1638-Hz spectral width with 6 × 6 mm2 in-plane resolution at 7 T. Phantom data indicated that dual-readout alternated gradients EPSI provides proper metabolite signals and induces much less frequency drifts than conventional EPSI. For a spatial resolution of 0.5 mL, 2HG was detected in tumors with precision (Cramer-Rao lower bound < 10%). The 2HG was estimated to be 2.3 to 3.3 mM in tumors of three patients with biopsy-proven isocitrate dehydrogenase (IDH) mutant gliomas. The 2HG was undetectable in an IDH wild-type glioblastoma. For a radiographically suggested glioma, the estimated 2HG of 2.3 ± 0.2 mM (Cramer-Rao lower bound < 10%) indicated that the lesion may be an IDH mutant glioma. CONCLUSIONS The data indicated that the dual-readout alternated gradients EPSI can provide reliable high-resolution imaging of 2HG in glioma patients at 7 T in vivo. Magn Reson Med 79:1851-1861, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Zhongxu An
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Vivek Tiwari
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Sandeep K Ganji
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jeannie Baxter
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Michael Levy
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Marco C Pinho
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Edward Pan
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Elizabeth A Maher
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Annette Strauss Center for Neuro-Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Toral R Patel
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Bruce E Mickey
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Annette Strauss Center for Neuro-Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Changho Choi
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Abstract
Primary brain tumors, most commonly gliomas, are histopathologically typed and graded as World Health Organization (WHO) grades I-IV according to increasing degrees of malignancy. These grades provide prognostic information and guidance on treatment such as radiation therapy and chemotherapy after surgery. Despite the confirmed value of the WHO grading system, results of a multitude of studies and prospective interventional trials now indicate that tumors with identical morphologic criteria can have highly different outcomes. Molecular markers can allow subtypes of tumors of the same morphologic type and WHO grade to be distinguished and are, therefore, of great interest in personalization of brain tumor treatment. Recent genomic-wide studies have resulted in a far more comprehensive understanding of the genomic alterations in gliomas and provide suggestions for a new molecularly based classification. Magnetic resonance (MR) imaging phenotypes can serve as noninvasive surrogates for tumor genotypes and can provide important information for diagnosis, prognosis, and, eventually, personalized treatment. The newly emerged field of radiogenomics allows specific MR imaging phenotypes to be linked with gene expression profiles. In this article, the authors review the conventional and advanced imaging features of three tumoral genotypes with prognostic and therapeutic consequences: (a) isocitrate dehydrogenase mutation; (b) the combined loss of the short arm of chromosome 1 and the long arm of chromosome 19, or 1p19q codeletion; and (c) methylguanine methyltransferase promoter methylation. © RSNA, 2017.
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Affiliation(s)
- Marion Smits
- From the Department of Radiology, Erasmus MC University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands (M.S.); and Brain Tumor Center, Erasmus MC Cancer Center, Rotterdam, the Netherlands (M.J.v.d.B.)
| | - Martin J van den Bent
- From the Department of Radiology, Erasmus MC University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands (M.S.); and Brain Tumor Center, Erasmus MC Cancer Center, Rotterdam, the Netherlands (M.J.v.d.B.)
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47
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Tietze A, Choi C, Mickey B, Maher EA, Parm Ulhøi B, Sangill R, Lassen-Ramshad Y, Lukacova S, Østergaard L, von Oettingen G. Noninvasive assessment of isocitrate dehydrogenase mutation status in cerebral gliomas by magnetic resonance spectroscopy in a clinical setting. J Neurosurg 2017; 128:391-398. [PMID: 28298040 DOI: 10.3171/2016.10.jns161793] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Mutations in the isocitrate dehydrogenase (IDH) genes are of proven diagnostic and prognostic significance for cerebral gliomas. The objective of this study was to evaluate the clinical feasibility of using a recently described method for determining IDH mutation status by using magnetic resonance spectroscopy (MRS) to detect the presence of 2-hydroxyglutarate (2HG), the metabolic product of the mutant IDH enzyme. METHODS By extending imaging time by 6 minutes, the authors were able to include a point-resolved spectroscopy (PRESS) MRS sequence in their routine glioma imaging protocol. In 30 of 35 patients for whom this revised protocol was used the lesions were subsequently diagnosed histologically as gliomas. Of the remaining 5 patients, 1 had a gangliocytoma, 1 had a primary CNS lymphoma, and 3 had nonneoplastic lesions. Immunohistochemistry and/or polymerase chain reaction 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 2 mM 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 2 IDH-mutated gliomas 2HG was not reliably detectable. CONCLUSIONS The noninvasive determination of the IDH mutation 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.
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Affiliation(s)
- Anna Tietze
- Departments of1Neuroradiology.,2Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus,Denmark; and
| | | | | | - Elizabeth A Maher
- 5Departments of Internal Medicine and Neurology & Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Ryan Sangill
- Departments of1Neuroradiology.,2Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus,Denmark; and
| | | | | | - Leif Østergaard
- Departments of1Neuroradiology.,2Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus,Denmark; and
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48
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Choi C, Raisanen JM, Ganji SK, Zhang S, McNeil SS, An Z, Madan A, Hatanpaa KJ, Vemireddy V, Sheppard CA, Oliver D, Hulsey KM, Tiwari V, Mashimo T, Battiste J, Barnett S, Madden CJ, Patel TR, Pan E, Malloy CR, Mickey BE, Bachoo RM, Maher EA. Prospective Longitudinal Analysis of 2-Hydroxyglutarate Magnetic Resonance Spectroscopy Identifies Broad Clinical Utility for the Management of Patients With IDH-Mutant Glioma. J Clin Oncol 2016; 34:4030-4039. [PMID: 28248126 DOI: 10.1200/jco.2016.67.1222] [Citation(s) in RCA: 138] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Proton magnetic resonance spectroscopy (MRS) of the brain can detect 2-hydroxyglutarate (2HG), the oncometabolite produced in neoplasms harboring a mutation in the gene coding for isocitrate dehydrogenase ( IDH). We conducted a prospective longitudinal imaging study to determine whether quantitative assessment of 2HG by MRS could serve as a noninvasive clinical imaging biomarker for IDH-mutated gliomas. Patients and Methods 2HG MRS was performed in 136 patients using point-resolved spectroscopy at 3 T in parallel with standard clinical magnetic resonance imaging and assessment. Data were analyzed in patient cohorts representing the major phases of the glioma clinical course and were further subgrouped by histology and treatment type to evaluate 2HG. Histologic correlations were performed. Results Quantitative 2HG MRS was technically and biologically reproducible. 2HG concentration > 1 mM could be reliably detected with high confidence. During the period of indolent disease, 2HG concentration varied by less than ± 1 mM, and it increased sharply with tumor progression. 2HG concentration was positively correlated with tumor cellularity and significantly differed between high- and lower-grade gliomas. In response to cytotoxic therapy, 2HG concentration decreased rapidly in 1p/19q codeleted oligodendrogliomas and with a slower time course in astrocytomas and mixed gliomas. The magnitude and time course of the decrease in 2HG concentration and magnitude of the decrease in tumor volume did not differ between oligodendrogliomas treated with temozolomide or carmustine. Criteria for 2HG MRS were established to make a presumptive molecular diagnosis of an IDH mutation in gliomas technically unable to undergo a surgical procedure. Conclusion 2HG concentration as measured by MRS was reproducible and reliably reflected the disease state. These data provide a basis for incorporating 2HG MRS into clinical management of IDH-mutated gliomas.
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Affiliation(s)
- Changho Choi
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Jack M Raisanen
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Sandeep K Ganji
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Song Zhang
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Sarah S McNeil
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Zhongxu An
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Akshay Madan
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Kimmo J Hatanpaa
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Vamsidhara Vemireddy
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Christie A Sheppard
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Dwight Oliver
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Keith M Hulsey
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Vivek Tiwari
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Tomoyuki Mashimo
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - James Battiste
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Samuel Barnett
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Christopher J Madden
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Toral R Patel
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Edward Pan
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Craig R Malloy
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Bruce E Mickey
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Robert M Bachoo
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
| | - Elizabeth A Maher
- All authors: University of Texas Southwestern Medical Center; and Craig R. Malloy, Veterans Affairs North Texas Health System, Dallas, TX
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49
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In-vivo brain H1-MR-Spectroscopy identification and quantification of 2-hydroxyglutarate in L-2-Hydroxyglutaric aciduria. Brain Res 2016; 1648:506-511. [DOI: 10.1016/j.brainres.2016.08.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 08/10/2016] [Accepted: 08/11/2016] [Indexed: 12/24/2022]
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50
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Abstract
The resurgence of research into cancer metabolism has recently broadened interests beyond glucose and the Warburg effect to other nutrients, including glutamine. Because oncogenic alterations of metabolism render cancer cells addicted to nutrients, pathways involved in glycolysis or glutaminolysis could be exploited for therapeutic purposes. In this Review, we provide an updated overview of glutamine metabolism and its involvement in tumorigenesis in vitro and in vivo, and explore the recent potential applications of basic science discoveries in the clinical setting.
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Affiliation(s)
- Brian J. Altman
- Abramson Family Cancer Research Institute, Perelman School of
Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Abramson Cancer Center, Perelman School of Medicine, University of
Pennsylvania, Philadelphia, PA, 19104, USA
- Division of Hematology-Oncology, Department of Medicine, Perelman
School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Zachary E. Stine
- Abramson Family Cancer Research Institute, Perelman School of
Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Abramson Cancer Center, Perelman School of Medicine, University of
Pennsylvania, Philadelphia, PA, 19104, USA
- Division of Hematology-Oncology, Department of Medicine, Perelman
School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Chi V. Dang
- Abramson Family Cancer Research Institute, Perelman School of
Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Abramson Cancer Center, Perelman School of Medicine, University of
Pennsylvania, Philadelphia, PA, 19104, USA
- Division of Hematology-Oncology, Department of Medicine, Perelman
School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
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