The investigation of metabolic pathways disturbed in isocitrate dehydrogenase (IDH) mutant tumors revealed that the hallmark metabolic alteration is the production of D-2-hydroxyglutarate (D-2HG). The biological impact of D-2HG strongly suggests that high levels of this metabolite may play a central role in propagating downstream the effects of mutant IDH, leading to malignant transformation of cells. Hence, D-2HG may be an ideal biomarker for both diagnosing and monitoring treatment response targeting IDH mutations. Magnetic resonance spectroscopy (MRS) is well suited to the task of noninvasive D-2HG detection, and there has been much interest in developing such methods. Here, we review recent efforts to translate methodology using MRS to reliably measure in vivo D-2HG into clinical research.
Ovidiu C. Andronesi, Otto Rapalino, Elizabeth Gerstner, Andrew Chi, Tracy T. Batchelor, Dan P. Cahill, A. Gregory Sorensen, Bruce R. Rosen
Summary of in vivo 1H MRS methods used in the literature for detection of D-2HG in patients with mutant IDH glioma