2H-magnetic resonance spectroscopy (MRS) recently emerged as a novel, non-invasive method of monitoring metabolic fluxes in high-grade glioblastomas in vivo. However, its utility for imaging low-grade gliomas and for assessing treatment response has not been examined. Here, we show that [6,6’-2H]-glucose metabolism to lactate serves to delineate tumor from contralateral normal brain in mice bearing orthotopic patient-derived low-grade glioma xenografts. Importantly, reduced lactate production from [6,6’-2H]-glucose informs on early response to therapy, at timepoints when volumetric alterations cannot be detected by anatomical imaging, pointing to the ability of [6,6’-2H]-glucose to assess pseudoprogression, which is a major challenge in glioma imaging.
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