2-hydroxyglutarate

Last revised by Dr Joshua Yap on 24 Aug 2022

2-hydroxyglutarate (2HG) is a metabolite that accumulates in the brains of patients with IDH1 mutated (IDH1 positive) brain tumors, particularly diffuse low-grade gliomas. Although not in widespread clinical use, it is likely that 2-hydroxyglutarate, which resonates at 2.25 ppm, will be able to be detected in vivo using MR spectroscopy (MRS), and thus IDH1 status could be detected preoperatively 1. This is important, as IDH1-mutant tumors carry a significantly better prognosis than IDH1-wildtype tumors.

Unfortunately, as it is a small peak, nestled among the GABA and glutamate/glutamine peaks (which overlap as it is), it requires more advanced MRS and post-processing techniques than those that are currently routinely available.

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