European Radiology

, Volume 29, Issue 3, pp 1203–1210 | Cite as

Amid proton transfer (APT) and magnetization transfer (MT) MRI contrasts provide complimentary assessment of brain tumors similarly to proton magnetic resonance spectroscopy imaging (MRSI)

  • Changliang Su
  • Lingyun Zhao
  • Shihui Li
  • Jingjing Jiang
  • Kejia Cai
  • Jingjing Shi
  • Yihao Yao
  • Qilin Ao
  • Guiling Zhang
  • Nanxi Shen
  • Shan Hu
  • Jiaxuan Zhang
  • Yuanyuan Qin
  • Wenzhen ZhuEmail author



Using MRSI as comparison, we aimed to explore the difference between amide proton transfer (APT) MRI and conventional semi-solid magnetization transfer ratio (MTR) MRI, and to investigate if molecular APT and structural MTR can provide complimentary information in assessing brain tumors.


Seventeen brain tumor patients and 17 age- and gender-matched volunteers were included and scanned with anatomical MRI, APT and MT-weighted MRI, and MRSI. Multi-voxel choline (Cho) and N-acetylaspartic acid (NAA) signals were quantified from MRSI and compared with MTR and MTRasym(3.5ppm) contrasts averaged from corresponding voxels. Correlations between contrasts were explored voxel-by-voxel by pooling values from all voxels into Pearson’s correlation analysis. Differences in correlation coefficients were tested with the Z-test (set at p<0.05).


APT and MT provide good contrast and quantitative parameters in tumor imaging, as do the metabolite (Cho and NAA) maps. MTRasym(3.5ppm) significantly correlated with MTR (R=-0.61, p<0.0001), Cho (R=0.568, p<0.0001) and NAA (R=-0.619, p<0.0001) in tumors, and MTR also significantly correlated with Cho (R=-0.346, p<0.0001) and NAA (R=0.624, p<0.0001). In healthy volunteers, MTRasym(3.5ppm) was non-significantly correlated with MTR (R=-0.049, p=0.239), Cho (R=0.030, p=0.478) and NAA (R=-0.083, p=0.046). Significant correlations were found among MTR with Cho (R=0.199, p<0.0001) and NAA (R=0.263, p<0.0001) in the group of healthy volunteers with lower correlation R values than those in tumor patients.


APT and MT could provide independent and supplementary information for the comprehensive assessment of molecular and structural changes due to brain tumor cancerogenesis.

Key Points

• MTR asym(3.5ppm) positively correlated with Cho while negatively with NAA in tumors.

• MTR positively correlated with NAA while negatively with Cho in tumors.

• Combining APT/MT provides molecular and structural information similarly to MRSI.


Amide proton transfer Magnetization transfer Magnetic resonance spectroscopic imaging Brain tumor 



Amide proton transfer


Magnetic resonance spectroscopy imaging


Magnetization transfer


Conventional magnetization transfer ratio


Asymmetrical magnetization transfer ratio at 3.5 ppm



We thank Bing Wu from GE health for his generous help in data post-processing and advice on the manuscript. We also acknowledge Dr. Yang Fan from General Electric Company (China) for his generous contributions to manuscript revision.


This study has received funding by grants from the National Program of the Ministry of Science and Technology of China during the “12th Five-Year Plan” (ID: 2011BAI08B10) and the National Natural Science Foundation of China (No. 81171308, No. 81570462, No. 81730049 and No. 81401389). This work is also partially supported by NIH NIBIB grant R21-EB023516-02 (Cai).

Compliance with ethical standards


The scientific guarantor of this publication is Wenzhen Zhu.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.


• Prospective

• Observational

• Performed at one institution


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Changliang Su
    • 1
  • Lingyun Zhao
    • 1
  • Shihui Li
    • 1
  • Jingjing Jiang
    • 1
  • Kejia Cai
    • 2
  • Jingjing Shi
    • 1
  • Yihao Yao
    • 1
  • Qilin Ao
    • 3
  • Guiling Zhang
    • 1
  • Nanxi Shen
    • 1
  • Shan Hu
    • 1
  • Jiaxuan Zhang
    • 1
  • Yuanyuan Qin
    • 1
  • Wenzhen Zhu
    • 1
    Email author
  1. 1.Department of Radiology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyHankouPeople’s Republic of China
  2. 2.The Department of Radiology and Bioengineering, College of MedicineUniversity of Illinois at ChicagoChicagoUSA
  3. 3.Department of Pathology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyHankouPeople’s Republic of China

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