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Improved localisation for 2-hydroxyglutarate detection at 3T using long-TE semi-LASER.

Adam Berrington1, Natalie L Voets1, Puneet Plaha2

  • 1FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom.

Tomography (Ann Arbor, Mich.)
|August 23, 2016
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Summary

Detecting 2-hydroxyglutarate (2-HG) in glioma patients is challenging. An optimized semi-LASER magnetic resonance spectroscopy method improves 2-HG detection in IDH-mutated tumors at 3T.

Keywords:
2-HG3TMRSgliomasemi-LASER

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Area of Science:

  • Neuroimaging
  • Biochemistry
  • Oncology

Background:

  • 2-hydroxyglutarate (2-HG) is a key biomarker for IDH-mutated gliomas, crucial for differential diagnosis.
  • Detecting 2-HG using 3 Tesla magnetic resonance spectroscopy (MRS) is difficult due to signal overlap and spectral complexities.
  • Existing PRESS sequences face limitations in accurately localizing and detecting the 2-HG spin system.

Purpose of the Study:

  • To optimize magnetic resonance spectroscopy (MRS) for improved detection of 2-hydroxyglutarate (2-HG) in glioma patients.
  • To evaluate an optimized semi-LASER sequence for 2-HG detection at 3 Tesla.
  • To compare the performance of the optimized semi-LASER sequence against a standard PRESS sequence for in vivo metabolite detection.

Main Methods:

  • Utilized density matrix simulations and phantom experiments to develop and test MRS sequences.
  • Implemented an optimized semi-LASER sequence with a long echo time (TE = 110 ms).
  • Compared the optimized semi-LASER sequence with an existing PRESS sequence for 2-HG detection in IDH-mutated gliomas.

Main Results:

  • The optimized semi-LASER sequence significantly improved the localization of the 2-HG spin system compared to PRESS.
  • A visible 2-HG peak at 1.9 ppm was detected in vivo in the majority of IDH-mutated gliomas using the semi-LASER method.
  • While 2-HG concentrations were similar, semi-LASER yielded narrower confidence intervals and reduced signal overlap with glutamate and glutamine.
  • Lactate was readily detectable across glioma patients with a mean CLRB of (10±2)%.

Conclusions:

  • Long echo time semi-LASER MRS at 3T offers enhanced and more robust detection of 2-hydroxyglutarate (2-HG) in gliomas.
  • This optimized method facilitates better in vivo investigation of tumor metabolism and patient stratification.
  • The improved detection capabilities hold promise for advancing the differential diagnosis and management of glioma patients.