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Purpose <p>To evaluate the diagnostic accuracy of three proton magnetic resonance spectroscopy (1H-MRS) strategies—short echo (TE 30 ms), intermediate echo (TE 97 ms), and MEGA-PRESS—for detecting the oncometabolite 2-hydroxyglutarate (2HG) to non-invasively determine isocitrate dehydrogenase (IDH) mutation status in adult-type diffuse gliomas.</p> Methods <p>A cohort of 152 patients with adult-type diffuse gliomas (84 IDH-mutant, 68 IDH-wild-type) underwent preoperative 3T MRI incorporating standard morphological sequences and 1H-MRS acquisitions. Spectra were evaluated to assess the presence of a 2HG peak. Diagnostic performance was analysed independently for each method and collectively for a subgroup of patients receiving all three sequences.</p> Results <p>The intermediate echo (TE 97 ms) method demonstrated 100% specificity and 51.2% sensitivity, while the short echo (TE 30 ms) sequence achieved 97% specificity and 88.9% sensitivity. The MEGA-PRESS method yielded 86.7% specificity and 72.2% sensitivity but was limited by a high non-diagnostic rate (17.5%) due to artifact susceptibility. When combined, the spectroscopy methods achieved 100% sensitivity, 85.7% specificity, and 93.7% overall accuracy in detecting 2HG.</p> Conclusion <p>Conventional PRESS sequences (TE 30 ms and TE 97 ms) outperform MEGA-PRESS for the routine clinical detection of 2HG due to higher technical reliability. An optimized conventional PRESS protocol offers a robust, highly accurate, and non-invasive preoperative tool for identifying glioma genotypes and predicting tumour phenotypes.</p>

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Diagnostic accuracy of 1H-MRS in detecting the oncometabolite 2-hydroxyglutarate (2HG) in adult-type diffuse gliomas

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月14日

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  • Anna Hebda,
  • Paweł Wawrzyniak,
  • Sylwia Heinze,
  • Patrycja Mazgaj,
  • Daniel Sadowski,
  • Małgorzata Oczko-Wojciechowska,
  • Elżbieta Nowicka,
  • Ewa Chmielik,
  • Barbara Bobek-Billewicz

摘要

Purpose

To evaluate the diagnostic accuracy of three proton magnetic resonance spectroscopy (1H-MRS) strategies—short echo (TE 30 ms), intermediate echo (TE 97 ms), and MEGA-PRESS—for detecting the oncometabolite 2-hydroxyglutarate (2HG) to non-invasively determine isocitrate dehydrogenase (IDH) mutation status in adult-type diffuse gliomas.

Methods

A cohort of 152 patients with adult-type diffuse gliomas (84 IDH-mutant, 68 IDH-wild-type) underwent preoperative 3T MRI incorporating standard morphological sequences and 1H-MRS acquisitions. Spectra were evaluated to assess the presence of a 2HG peak. Diagnostic performance was analysed independently for each method and collectively for a subgroup of patients receiving all three sequences.

Results

The intermediate echo (TE 97 ms) method demonstrated 100% specificity and 51.2% sensitivity, while the short echo (TE 30 ms) sequence achieved 97% specificity and 88.9% sensitivity. The MEGA-PRESS method yielded 86.7% specificity and 72.2% sensitivity but was limited by a high non-diagnostic rate (17.5%) due to artifact susceptibility. When combined, the spectroscopy methods achieved 100% sensitivity, 85.7% specificity, and 93.7% overall accuracy in detecting 2HG.

Conclusion

Conventional PRESS sequences (TE 30 ms and TE 97 ms) outperform MEGA-PRESS for the routine clinical detection of 2HG due to higher technical reliability. An optimized conventional PRESS protocol offers a robust, highly accurate, and non-invasive preoperative tool for identifying glioma genotypes and predicting tumour phenotypes.