RESUMO
PURPOSE: To test the efficacy of 7T MRS for in vivo detection of 2-hydroxyglutarate (2HG) in brain tumors. METHODS: The subecho times of point-resolved spectroscopy (PRESS) were optimized at 7T with density-matrix simulations and phantom validation to improve the 2HG signal selectivity with respect to the neighboring resonances of γ-aminobutyric acid (GABA), glutamate (Glu), and glutamine (Gln). MRS data were acquired from 12 subjects with gliomas in vivo and analyzed with LCModel using calculated basis spectra. Metabolite levels were quantified using unsuppressed short echo time (TE) water as a reference. RESULTS: The PRESS TE was optimized as TE = 78 ms (TE1 = 58 ms and TE2 = 20 ms), at which the 2HG 2.25 ppm resonance appeared as a temporally maximum inverted narrow peak and the GABA, Glu, and Gln resonances between 2.2 and 2.5 ppm were all positive peaks. The PRESS TE = 78 ms method offered improved discrimination of 2HG from Glu, Gln, and GABA when compared with short-TE MRS. 2HG was detected in all patients enrolled in the study, the estimated 2HG concentrations ranging from 1.0 to 6.2 mM, with percentage standard deviation of 2%-7%. CONCLUSION: Data indicate that the optimized MRS provides good selectivity of 2HG from other metabolite signals and may confer reliable in vivo detection of 2HG at relatively low concentrations. Magn Reson Med 77:936-944, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
Assuntos
Algoritmos , Biomarcadores Tumorais/metabolismo , Neoplasias Encefálicas/metabolismo , Glutaratos/metabolismo , Espectroscopia de Ressonância Magnética/métodos , Processamento de Sinais Assistido por Computador , Encéfalo/metabolismo , Encéfalo/patologia , Neoplasias Encefálicas/patologia , Humanos , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
PURPOSE: To examine in vivo metabolic alterations in the isocitrate dehydrogenase (IDH) mutated gliomas using magnetic resonance spectroscopy (MRS) at magnetic field 9.4T. MATERIALS AND METHODS: Spectra were acquired with a 9.4T whole-body scanner with the use of a custom-built head coil (16 channel transmit and 31 channel receive). A modified stimulated echo acquisition mode (STEAM) sequence was used for localization. Eighteen patients with brain tumors of probable glial origin participated in this study. The study was performed in accordance with the guidelines of the local Ethics Committee. RESULTS: The increased spectral resolution allowed us to directly address metabolic alterations caused by the specific pathophysiology of IDH mutations including the presence of the oncometabolite 2-hydroxglutarate (2HG) and a significant decrease of the pooled glutamate and glutamine (20%, P = 0.024), which probably reflects an attempt to replenish α-ketoglutarate lost by conversion to 2HG. We also observed significantly reduced glutathione (GSH) levels (39%, P = 0.019), which could be similarly caused by depletion of dihydronicotinamide-adenine dinucleotide phosphate (NADPH) during this conversion in IDH mutant gliomas. CONCLUSION: We demonstrate that MRS at 9.4T provides a noninvasive measure of 2HG in vivo, which may be used for therapy planning and prognostication, and may provide insights into related pathophysiologic metabolic alterations associated with IDH mutations. J. MAGN. RESON. IMAGING 2016;44:823-833.
Assuntos
Oxirredutases do Álcool/genética , Algoritmos , Biomarcadores Tumorais/metabolismo , Neoplasias Encefálicas/metabolismo , Glioma/metabolismo , Glutaratos/metabolismo , Espectroscopia de Ressonância Magnética/métodos , Biomarcadores Tumorais/genética , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/patologia , Glioma/genética , Glioma/patologia , Humanos , Imagem Molecular/métodos , Mutação/genética , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
Aquaporin 4 (AQP4) is an ubiquitously expressed membrane protein channel found in the central nervous system and mainly on astrocytes. Recent studies on AQP4 has implicated it in tumorigenesis. It is of interest to determine the potential value of AQP4 in identifying, guiding treatment and prognosticating various types of CNS cancers. This investigation systematically investigated the oncogenic role of AQP4 across 33 CNS tumors found in GEO and TCGA datasets. We found that CNS tumors strongly expressed AQP4. There appeared to be a strong link between the prognosis of patients with a CNS malignancy and degree of AQP4 expression. AQP4 expression influences the degree of CD8+ T-cell infiltration level as well as cancer-associated fibroblast infiltration in CNS tumors. Moreover, synaptic vesicle cycle and phosphatidylinositol signaling system-associated functions were also found to be related to AQP4 functional mechanisms. Furthermore, potential AQP4 inhibitors have also been explored by using Specs data base and virtual screening technique. This study contributes toward current knowledge regarding the role of AQP4 in CNS tumors.