The role of 2-hydroxyglutarate magnetic resonance spectroscopy for the determination of isocitrate dehydrogenase status in lower grade gliomas versus glioblastoma: a systematic review and meta-analysis of diagnostic test accuracy

Bhandari, A; Sharma, C; Ibrahim, M; Riggs, M; Jones, R; Lasocki, A

Author(s): Bhandari, A; Sharma, C; Ibrahim, M; Riggs, M; Jones, R; Lasocki, A;
Details: Publication Year 2021-11,Volume 63,Issue #11,Page 1823-1830
Journal Title: Neuroradiology
Publication Type: Review
Abstract: PURPOSE: Magnetic resonance spectroscopy (MRS) provides a non-invasive means of determining isocitrate dehydrogenase (IDH) status. Determination of 2-hydroxyglutarate (2-HG) presence through MRS is a means of determining IDH status; however, differences may be seen by grade. The goal of this paper is to perform a diagnostic test accuracy (DTA) meta-analysis on 2-HG MRS for IDH status in both lower-grade glioma (LGG) and glioblastoma (GBM) in preoperative patients. METHODS: A systematic review and meta-analysis were performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Diagnostic Test Accuracy guidelines. Quality assessment was performed using the Quality Assessment of Diagnostic Accuracy Studies 2. The search was up to date as of 09/02/2021. Nine English-language journal articles were included. RESULTS: The meta-analysis found a pooled sensitivity of 93% (95% CI 58-99%) and specificity of 84% (95% CI 51-96%) for LGG (n= 181). For GBM (n= 77), the pooled sensitivity was 84% (95% CI 25.0-99%) and the specificity was 97% (95% CI 43-100%). CONCLUSION: 2-HG MRS shows promise as a non-invasive means of determining IDH status, with specificity higher for GBM and sensitivity higher for LGG. The wide confidence intervals are notable, however, in particular related to the small number of IDH-mutant GBM studied. Diagnostic heterogeneity was particularly present for LGG, and the hierarchical summary receiver operator curves showed poor predictive accuracy in both groups. For more conclusive results, diagnostic test accuracy statistics need to be quantified with larger studies and more deliberate study design.
Keywords: *Brain Neoplasms/diagnostic imaging; Diagnostic Tests, Routine; *Glioblastoma; *Glioma/diagnostic imaging; Glutarates; Humans; Isocitrate Dehydrogenase/genetics; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Mutation
Department(s): Cancer Imaging
PubMed ID: 33811494
Publisher's Version: https://doi.org/10.1007/s00234-021-02702-1
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2025-06-06 07:51:51

Last Modified: 2025-06-06 07:57:04