Bibliographic record
Abstract
Isocitrate dehydrogenase (IDH) enzymes are a key element in the Krebs cycle and therefore cellular homoeostasis. Whole brain three-dimensional spectroscopic imaging is a feasible tool to display global metabolic reprogramming driven by IDH mutation seen in gliomas. We conducted a prospective longitudinal observational study recruiting WHO grade II-IV IDH mutant and IDH wildtype glioma patients undergoing surgical resection at the Montreal Neurological Institute. MIDAS software was used for processing and segmentation of three-dimensional echoplanar spectroscopic imaging obtained pre-operatively and 2 weeks after surgery. Parametric maps of N-Acetylspartate (NAA), Choline, GLX (Glutamine +Glutamate), Creatine and lactate were computed and co-registered on FLAIR images using MRIcrogl software. In total, 8 patients were recruited (5 IDH mutant and 3 IDH Wildtype) as well as 4 healthy controls. We analyzed the mean regional concentrations (Choline, Creatine, Lactate, NAA, GLX, Glu, Gln) and LAC/NAA, Cho/NAA ratios for 26 regions of interest (ROI) including tumoral, peritumoral and contralateral areas. Compared to healthy control and IDH wildtype, IDH mutant tumoral area showed a drop in the concentration of glutamate (P=0.025) with higher levels of glutamine (P=0.001), Choline (P=0.001) and overall reduction in GLX concentration (P=0.018). IDH wild-type tumoral area showed higher concentration of lactate (P=0.001). Among IDH mutants, peritumoral area had significant drop of choline (P=0.001) and Taurine (0.027), higher concentration of glutamate (P=0.001) with lower Cho/NAA ratios below 1. Post-operatively, Glutamate was higher at the surgical margin when compared to pre-operative peritumoral areas (0.023). Analysis of contralateral areas showed no significant difference in the metabolites of interest for both IDH mutant and wildtype glioma. Taken all together, these metabolic changes reflect an IDH-mediated increase in cellular density with higher energy demand captured in these tumors. Additionally, metabolic changes seen in peritumoral area could offer a potential marker for tumor border guiding surgical resection. Furthermore, whole brain spectroscopy offers a potential tool in IDH mutant post-operative assessment. Finally, in the absence of contralateral metabolic alterations, we suggest that IDH mutation affect tumoral and peritumoral area metabolites with no global impact detected
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".