体内代谢谱的 P 和短 TE H MRS 光谱测定：IDH 野生型和 IDH 突变型胶质瘤患者之间无差异。
In vivo Metabolic Profiles as Determined by P and short TE H MR-Spectroscopy : No Difference Between Patients with IDH Wildtype and IDH Mutant Gliomas.
机构信息
Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany.
出版信息
Clin Neuroradiol. 2019 Mar;29(1):27-36. doi: 10.1007/s00062-017-0630-8. Epub 2017 Oct 5.
PURPOSE
Previous ex vivo spectroscopic data from tissue samples revealed differences in phospholipid metabolites between isocitrate dehydrogenase mutated (IDHmut) and IDH wildtype (IDHwt) gliomas. We investigated whether these changes can be found in vivo using H-decoupled P magnetic resonance spectroscopic imaging (MRSI) with 3D chemical shift imaging (CSI) at 3 T in patients with low and high-grade gliomas.
METHODS
The study included 33 prospectively enrolled, mostly untreated patients who met spectral quality criteria according to the World Health Organization (WHO II n = 7, WHO III n = 17, WHO IV n = 9; 25 patients IDHmut, 8 patients IDHwt). The MRSI protocol included H decoupled P MRSI with 3D CSI (3D P CSI), 2D H CSI and a H single voxel spectroscopy sequence (TE 30 ms) from the tumor area. For H MRS, absolute metabolite concentration values were calculated (phantom replacement method). For P MRS, metabolite intensity ratios were calculated for the choline (C) and ethanolamine (E)-containing metabolites.
RESULTS
In our patient cohort we did not find significant differences for the ratio of phosphocholine (PC) and phosphoethanolamine (PE), PC/PE, (p = 0.24) for IDHmut compared to IDHwt gliomas. Furthermore, we found no elevated ratios of glycerophosphocholine (GPC) and glycerophosphoethanolamine (GPE), GPC/GPE, (p = 0.68) or GPC/PE (p = 0.12) for IDHmut gliomas. Even the ratio (PC+GPC)/(PE+GPE) showed no significant differences with respect to mutation status (p = 0.16). Nonetheless, changes related to tumor grade regarding intracellular pH (pH) and phospholipid metabolism as well as absolute metabolite concentrations of co-registered 2D H CSI data for tumor and control tissue showed the anticipated results.
CONCLUSION
Using 3D-CSI data acquisition, in vivo P MR spectroscopic measurement of phospholipid metabolites could not distinguish between IDHmut and IDHwt.
目的
先前来自组织样本的离体光谱数据显示，异柠檬酸脱氢酶突变（IDHmut）和 IDH 野生型（IDHwt）胶质瘤之间的磷脂代谢物存在差异。我们使用 3T 下的 H 去耦 P 磁共振波谱成像（MRSI）与三维化学位移成像（CSI），在低级别和高级别胶质瘤患者中研究了这些变化是否可以在体内发现。
方法
该研究纳入了 33 名前瞻性入组的、大多未经治疗的患者，根据世界卫生组织（WHO II n = 7、WHO III n = 17、WHO IV n = 9）的标准，他们符合光谱质量标准；25 名患者 IDHmut，8 名患者 IDHwt。MRSI 方案包括 H 去耦 P MRSI 与三维 CSI（3D P CSI）、2D H CSI 和肿瘤区域的 H 单体波谱序列（TE 30ms）。对于 H MRS，计算了绝对代谢物浓度值（幻影替换法）。对于 P MRS，计算了胆碱（C）和乙醇胺（E）含代谢物的代谢物强度比。
结果
在我们的患者队列中，我们没有发现 IDHmut 与 IDHwt 胶质瘤之间磷胆（PC）和磷乙醇胺（PE）的比值（PC/PE）、PC/PE（p = 0.24）有显著差异。此外，我们没有发现甘油磷胆（GPC）和甘油磷乙醇胺（GPE）、GPC/GPE（p = 0.68）或 GPC/PE（p = 0.12）的比值升高。即使是（PC+GPC）/（PE+GPE）的比值与突变状态也没有显著差异（p = 0.16）。尽管如此，与肿瘤分级相关的细胞内 pH（pH）和磷脂代谢以及肿瘤和对照组织的共配准 2D H CSI 数据的绝对代谢物浓度的变化显示出了预期的结果。
结论
使用 3D-CSI 数据采集，磷脂代谢物的体内 P MRS 测量无法区分 IDHmut 和 IDHwt。
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