Advances and Challenges in Assessing 2-Hydroxyglutarate in Gliomas by Magnetic Resonance Spectroscopy: A Short Review

The metabolite 2-hydroxyglutarate (2HG) accumulates in isocitrate dehydrogenase (IDH)- mutant gliomas and high-levels of 2HG can be non-invasively detected in living human brain by magnetic resonance spectroscopy (MRS). The concept of being able to detect a metabolite associated with an important gene mutation has generated considerable excitement in the fields of neurooncology and neuroradiology. However, challenges remain in reliably detecting 2HG before we can use it as a tool for making clinical decisions. In this review, we outline the advances and challenges in assessing 2HG by MRS.