Most MR spectroscopy studies of patients with IDH-mutated gliomas have focused on the sensitivity and specificity of the 2-hydroxyglutarate measures but none that have examined the predictive value of 2HG in comparison to other brain metabolites for treatment outcome. This prospective longitudinal study measured MRS at baseline and two time points after radio/chemotherapy of IDH-mutated gliomas. Results showed that Cho/NAA shows the greatest predictive value followed by Cho/Cr, NAA/Cr, and Lac/Cr ratios but that all three time points 2HG levels were not predictive of outcome demonstrating that it is likely reflective of pathways distinct from membrane proliferation.
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