Metabolic biomarkers of IDH status in gliomas by in vivo Magnetic Resonance Spectroscopy

Motivation: Reliable noninvasive quantification of D-2-hydroxyglutarate (2HG) for diagnosis of isocitrate dehydrogenase (IDH)-mutant gliomas is challenging. Goal(s): To discriminate between IDH-mutant and wild-type gliomas based on their full metabolic profile. Approach: Partial Least Squares Discriminant Analysis (PLS-DA) was used to discriminate IDH-mutants from wild-types using in vivo 3T MRS data from 47 patients with a newly diagnosed glioma. Results: Higher 2HG and lower glutamate + glutamine, glutamate, glycine, and glutathione were observed in IDH-mutants compared to wild-types. The PLS-DA model showed higher accuracy (AUC = 0.949) compared to 2HG alone (AUC = 0.753), underscoring the superiority of a comprehensive approach over single metabolite analysis.<hr align="left" size="1" width="33%">Impact: Exploring in vivo metabolic alterations beyond D-2-hydroxyglutarate is crucial for enhancing diagnostic accuracy in detection of IDH mutations in patients with gliomas, as well as for a deeper understanding of the fundamental biological consequences of this mutation.