Figure 4

Synopsis of how IDH mutation status is linked to angiogenesis and alteration in rCBV on DSC-MRI in human glioma based on this hypothesis generating study.
In brief, mutations in cancer-associated IDH acquire neoactivity producing 2-hydroxyglutarate (2HG). (R)-2HG potentiates EglN activity that mark the hypoxia inducible factor HIF1A for polyubiquitylation and proteasomal degradation, leading to decreased HIF1A activation in IDH mutant tumors, compared with their wild-type counterparts. This results in a distinct transcriptome signature induced by upregulation of hypoxia, vasculo- and angiogenesis related signaling pathways in IDH wild-type tumors, which is non-invasively detectable with rCBV imaging.