2-hydroxyglutarate is a metabolite that accumulates in the brains of patients with IDH-1 mutated (IDH-1 positive) brain tumors, particularly diffuse low-grade gliomas. Although not in widespread clinical use, it is likely that 2-hydroxyglutarate, which resonates at 2.25 ppm, will be able to be detected in vivo using MR spectroscopy (MRS), and thus IDH-1 status could be detected preoperatively . This is important, as it is increasingly recognized that IDH-1 status has a significant impact on prognosis.

Unfortunately, as it is a small peak, nestled among the GABA and glutamate/glutamine peaks (which overlap as it is), it requires more advanced MRS and post-processing techniques than those that are currently routinely available.