In vivo detection of GSH and GABA in high-grade glioma using MEGA-sLASER spectral editing at 3 T

Motivation: Alterations in glutamatergic and GABAergic (gamma-aminobutyric acid) mechanisms render peritumoral neuronal networks of infiltrating glioma hyper-excitable and more prone to seizures. Goal(s): Glutamate, glutamine, glutathione (GSH), and GABA are therefore key metabolites in glioma-associated epilepsy. Approach: Nowadays, J-editing MR spectroscopy is the primary technique in the detection of low-abundant metabolites (e.g., GSH, GABA) that overlap with more prominent signals. We used this technique combined with sLASER sequence (MEGA-sLASER) to improve localization accuracy and showed its reliability/repeatability for GSH and GABA quantification in glioblastoma, IDH-wildtype. Results: This approach could foster our understanding of the biological effects of novel drugs targeting tumor-associated epilepsy. Impact: MEGA-sLASER might improve the detectability and MRS localization accuracy of low-abundant metabolites (GSH, GABA) even in rather small, heterogeneous solid tumors. Here, we show the reliability/reproducibility of this method in the investigation of glioma-associated epilepsy in glioblastoma patients.