Artikel
Implementation of the modified PRESS sequence for the IDH Spectroscopy
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Veröffentlicht: | 18. Juni 2018 |
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Gliederung
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Objective: The presence of IDH mutation can be determined preoperatively and non-invasively using a technique of the MR spectroscopy. The usefulness of the method lies predominantly in the postoperative use, where it could be used to monitor therapy response, or to differentiate a recurrence from pseudoprogression. Prior to this use, however, a verification of the local implementation of this special method based on immunohistochemistry or sequencing has to be undertaken in order to avoid potential mistakes influencing treatment decisions. The aim of this study was to verify the local implementation of the modified PRESS sequence in a 3T Siemens Verio scanner.
Methods: The sequence was used in 15 patients with suspected low grade glioma between 2015 and 2017. The results of the determination of 2-hydroxyglutarate were compared with the immunohistochemical IDH status of the individual patients.
Results: Of the 15 patients 11 harbored an IDH - mutant tumor. In 12 cases the IDH status was preoperatively correctly determined using the above mentioned sequence. Of the three cases with incongruent results one case was false positive and one false negative. In one case the spectroscopy data were unusable for the analysis. All cases with incongruent results occurred during the 6 months of use of the sequence, at the begin of the implementation period.
Conclusion: Verification of the local implementation of the spectroscopy sequence is necessary in case of experimental methods like 2HG-MR spectroscopy. After initial errors the method promises to be reliable enough to support clinical decision-making.