Pitfalls in 2HG Detection With TE-Optimized MRS at 3T.
Overview
- Russell H. Morgan Department of Radiology and Radiological Science Johns Hopkins University School of Medicine Baltimore Maryland USA
- Institute of Neuroradiology and Cooperative Brain Imaging Center ‐ CoBIC University Hospital Frankfurt am Main Germany
- University Cancer Center Frankfurt (UCT) Frankfurt am Main Germany
- German Cancer Research Center (DKFZ) Frankfurt am Main Germany
- Frankfurt Cancer Institute (FCI) Frankfurt am Main Germany
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center Johns Hopkins University School of Medicine Baltimore Maryland USA
- Department of Neurology Johns Hopkins University School of Medicine Baltimore Maryland USA
- Department of Neurosurgery Johns Hopkins University School of Medicine Baltimore Maryland USA
- F. M. Kirby Research Center for Functional Brain Imaging Kennedy Krieger Institute Baltimore Maryland USA
Abstract
Background and Purpose: In vivo MRS of 2‐hydroxyglutarate (2HG) may provide diagnostic and monitoring biomarkers in isocitrate dehydrogenase (IDH)‐mutated glioma. A previous meta‐analysis has shown good diagnostic accuracy of TE‐optimized PRESS for IDH‐mutated glioma, but most studies feature IDH‐wildtype glioma as a comparison. However, when considering newly identified brain lesions that may mimic glioma, full characterization of its diagnostic utility should also consider the accuracy of 2HG measurement in nontumor tissue. Therefore, we tested how well TE‐optimized 2HG levels distinguish between IDH‐mutated glioma and nontumor tissue—here, normal‐appearing brain. We further examined the impact of different spectral modeling strategies (baseline stiffness, macromolecule inclusion, and basis set composition).
Methods: Forty‐eight patients with diagnosed/
Results: TE‐optimized PRESS distinguished IDH‐mutated glioma from nontumor tissue with lower sensitivity (range 0.76–0.62) and specificity (0.85–0.78) than the literature suggests for IDH‐mutated versus IDH‐wildtype glioma. Strong negative correlations between gamma‐aminobutyric acid (GABA) and 2HG persisted across all modeling strategies and may lead to false‐positive 2HG detection in nontumor tissue. We further present a cautionary example from a patient on a ketogenic diet, showing that ketone body acetone can interfere with 2HG detection.
Conclusions: Spectral overlap with GABA and acetone can lead to false‐positive 2HG detection in nontumor tissue.
Reproduced under the paper's license (CC BY), from the paper cited above.
Code
The paper says that its authors' code is available on request: it was not published with the paper, so there is nothing to verify.
The paper's code and data availability statement is in the Data section.
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Data
No dataset and no data link were found in the paper.
Data Availability Statement
MRS result tables and statistical analysis code that support the findings of this study are available from the corresponding author upon reasonable request.
Reproduced under the paper's license (CC BY), from the paper cited above.
Versions
The history of this record: each version stored by the harvester or made by a correction of its authors or of the maintainers of its code, and what changed in its facts. The texts of the paper (its abstract, its availability statements) are not part of it; versions that changed only those are not listed.
Version 3, 28 September 2026
- Publisher: — → Wiley
- Authors: added Seyma Alcicek (0000-0002-9447-4906); Lindsay Blair (0000-0001-7335-4537); Helge J. Zöllner (0000-0002-7148-292X); Georg Oeltzschner (0000-0003-3083-9811); removed Seyma Alcicek; Lindsay Blair; Helge J. Zöllner; Georg Oeltzschner
Version 1, 27 September 2026: the first record
Recorded: type, language, journal, volume, issue, pages, dates, 14 authors, 5 keywords, 13 MeSH terms, 2 funders, 45 references.
Cite
This paper
Alcicek, S., Simicic, D., Blair, L., Saint‐Germain, M., Zöllner, H. J., Davies‐Jenkins, C. W., Holdhoff, M., Laterra, J., Bettegowda, C., Schreck, K. C., Lin, D. D., Barker, P. B., Kamson, D. O., & Oeltzschner, G. (2026). Pitfalls in 2HG Detection With TE-Optimized MRS at 3T. Journal of neuroimaging : official journal of the American Society of Neuroimaging, 36(5), e70146. https://
BibTeX
@article{alcicek2026pitf
author = {Alcicek, Seyma and Simicic, Dunja and Blair, Lindsay and Saint‐Germain, Max and Zöllner, Helge J. and Davies‐Jenkins, Christopher W. and Holdhoff, Matthias and Laterra, John and Bettegowda, Chetan and Schreck, Karisa C. and Lin, Doris D. and Barker, Peter B. and Kamson, David O. and Oeltzschner, Georg},
title = {{Pitfalls in 2HG Detection With TE-Optimized MRS at 3T}},
journal = {Journal of neuroimaging : official journal of the American Society of Neuroimaging},
year = {2026},
month = sep,
volume = {36},
number = {5},
pages = {e70146},
publisher = {Wiley},
issn = {1051-2284},
doi = {10.1111/
url = {https://
pmid = {42742320},
pmcid = {PMC13576559}
}
RIS
TY - JOUR
AU - Alcicek, Seyma
AU - Simicic, Dunja
AU - Blair, Lindsay
AU - Saint‐Germain, Max
AU - Zöllner, Helge J.
AU - Davies‐Jenkins, Christopher W.
AU - Holdhoff, Matthias
AU - Laterra, John
AU - Bettegowda, Chetan
AU - Schreck, Karisa C.
AU - Lin, Doris D.
AU - Barker, Peter B.
AU - Kamson, David O.
AU - Oeltzschner, Georg
TI - Pitfalls in 2HG Detection With TE-Optimized MRS at 3T
T2 - Journal of neuroimaging : official journal of the American Society of Neuroimaging
J2 - J Neuroimaging
PY - 2026
DA - 2026/
VL - 36
IS - 5
SP - e70146
SN - 1051-2284
PB - Wiley
DO - 10.1111/
UR - https://
LA - en
ER -
CSL-JSON
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