Anna Tietze, 2015
Although morphologically similar, glioblastoma multiforme (GBM) and other primary brain tumours constitute a heterogeneous group with different clinical outcome. Advances in genetic technology have led to the discovery of numerous mutations that provide us with an insight into the complexity of tumorigenesis. Better understanding of the pathophysiology of these tumours will allow the development of novel therapies targeted at mutations, growth hormones, cell receptors etc.
Some of these molecular markers have made their way into the clinical routine and thereby facilitate for individualised therapy options with potentially better outcome. One of those is the mutation of isocitrate dehydrogenase (IDH), which can be detected in tissue samples by means of immunohistochemistry. IDH mutation leads to the accumulation of the under normal circumstances nearly non-existing metabolite 2-hydroxyglutarate (2-HG) that has recently been shown to be detectable with MR spectroscopy (MRS). Thus, MRS permits diagnosis and follow-up of these tumours non-invasively.
Is 2-HG MRS feasible on a clinical MRI system, and are MRI spectra correlated with IDH mutations in tissue specimens?
Are IDH mutations in glioma tissue correlated with altered diffusion and perfusion properties assessed by Diffusion Kurtosis Imaging and advanced perfusion-weighted MRI suggesting hypoxia and increased cellularity?
This is an on-going project. Patients are included pre-surgically after giving informed consent. MRI parameters are compared to histopathology and IDH mutational status assessed by immunohistochemistry or PCR.
Anna Tietze, MD, PhD