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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

  • Diagnostic Neuroradiology
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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.

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Change history

  • 07 April 2021

    Supplementary material has been updated

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Funding

Arian Lasocki was supported by a Peter MacCallum Cancer Foundation Discovery Partner Fellowship.

Author information

Author notes

  1. Chinmay Sharma and Muhammad Ibrahim contributed equally to this work.

Authors and Affiliations

  1. Townsville University Hospital, 100 Angus Smith Drive, Douglas, Queensland, 4814, Australia

    Abhishta Bhandari & Matthew Riggs

  2. James Cook University, Douglas, Townsville, Queensland, Australia

    Chinmay Sharma, Muhammad Ibrahim & Rhondda Jones

  3. Department of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia

    Arian Lasocki

  4. Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia

    Arian Lasocki

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  1. Abhishta Bhandari
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Correspondence to Abhishta Bhandari.

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Bhandari, A., Sharma, C., Ibrahim, M. et al. 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. Neuroradiology 63, 1823–1830 (2021). https://doi.org/10.1007/s00234-021-02702-1

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