Evidence map›Paper›PMID 34985589›Full record

ArticleMagma (New York, N.Y.)2022

Diagnostic performance of edited 2HG MR spectroscopy of central glioma in the clinical environment.

Dominik Juskanič, Jana Poláková Mištinová, Samuel Hollý, Monika Sekerešová, Kamil Koleják, Lukáš Pátrovič

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Article in Magma (New York, N.Y.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Dominik JuskaničJESSENIUS-Diagnostic Center, Nitra, Slovakia. juskanic.dominik@jessenius.sk.ORCID http://orcid.org/0000-0001-7652-2284
Jana Poláková MištinováMedical Faculty, Comenius University in Bratislava, Bratislava, Slovakia.
Samuel HollýJESSENIUS-Diagnostic Center, Nitra, Slovakia.
Monika SekerešováFaculty Hospital, Nitra, Slovakia.
Kamil KolejákFaculty Hospital, Nitra, Slovakia.
Lukáš PátrovičJESSENIUS-Diagnostic Center, Nitra, Slovakia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveOncometabolite D-2-hydroxyglutarate (2HG) is pooled in isocitrate dehydrogenase (IDH)-mutant glioma cells. Detecting 2HG by MR spectroscopy (MRS) has been proven viable in the last decade but has not entirely found its way into the clinical routine. This study aimed to explore the adoption of 2HG MRS while acknowledging factors that influence its performance in the clinical environment.

methodsThirty-nine MR spectra were acquired and reported prospectively in patients with suspected glioma using a 3 T system with Mescher-Garwood point-resolved spectroscopy (MEGA-PRESS) sequence utilizing averaged free induction decay (FID) signals. Postprocessing and evaluation of spectra were performed with jMRUI and LCModel. 2HG concentration estimates, 2HG/Cr ratio, together with quality measures, including Cramér-Rao lower bounds (CRLBs), full-width at half-maximum (FWHM) values, and signal-to-noise ratio (SNR) were calculated using LCModel. Immunohistochemistry and genomic analysis results used as a ground truth were available for 15 patients.

resultsThe threshold for test positivity was set according to the ROC curve at 1 mM. Calculated sensitivity was 57.14% (95% CI 0.20-0.88), specificity 87.5% (95% CI 0.46-0.99), positive predictive value 80%, and negative predictive value 70%. Overall diagnostic accuracy was 73.33% (95% CI 0.45-0.92). The 2HG/Cr ratio with the cutoff value 0.085 significantly improved sensitivity and overall diagnostic accuracy [85.71%, 95% CI 0.42-1.00 and 86.67%, (95% CI 0.60-0.98), respectively].

conclusionMultiple factors compromising spectral quality in the clinical adoption of edited 2HG MRS resulted in diminished sensitivity but clinically acceptable specificity. Furthermore, the 2HG/Cr ratio performs better than the sole 2HG concentration estimate in the pre-operative setting.

Indexed as

Brain NeoplasmsGliomaGlutaratesMagnetic Resonance SpectroscopyHumansIsocitrate Dehydrogenasealpha-hydroxyglutarateGlutaratesIsocitrate Dehydrogenase2-HydroxyglutarateBrain gliomaMEGA-PRESSSensitivitySpecificity

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.