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• Clinical Article •
The feasibility of fluid-suppressed amide proton transfer-weighted imaging in suppressing the fluid components of post-treatment gliomas
HOU Jingwen  ZHANG Chi  SU Chunqiu  ZHAO Xiance  CAO Yuandong  LU Shanshan 

Cite this article as: HOU J W, ZHANG C, SU C Q, et al. The feasibility of fluid-suppressed amide proton transfer-weighted imaging in suppressing the fluid components of post-treatment gliomas[J]. Chin J Magn Reson Imaging, 2025, 16(9): 40-45. DOI:10.12015/issn.1674-8034.2025.09.007.


[Abstract] Objective To investigate the feasibility of fluid-suppressed amide proton transfer-weighted imaging (FS-APTw) in suppressing the fluid components of post-treatment gliomas.Materials and Methods Fifty-nine patients with surgically and pathologically confirmed gliomas who received standard postoperative chemoradiotherapy were prospectively collected and underwent APTw and FS-APTw imaging. The APTw and FS-APTw maps were coregistered and fused with anatomical maps to extract APTw and FS-APTw values from fluid components, peri-lesion edema, and measurable enhancing regions of gliomas. Comparisons were made using the paired-samples t-test or Wilcoxon signed ranks test. Subgroup analyses were performed according to the characteristics of the fluid compartments on FLAIR and DWI images (Group 1, low signal on both FLAIR and DWI; Group 2, equal or high signal on FLAIR but low signal on DWI; Group 3, equal or high signal on FLAIR and high or mixed signals on DWI). The efficacy of fluid suppression among the three groups was compared using the Kruskal-Wallis test, followed by the post-hoc tests.Results After the use of fluid suppression, the FS-APTw values of the fluid and edema compartments were significantly decreased, as compared to their corresponding APTw values (1.37% vs. 1.67%, 1.03% vs. 1.14%) (both P < 0.05). No significant difference was found in enhancing compartments (2.16% vs. 2.22%, P = 0.404). The subgroup analysis showed notable differences in the baseline APTw values of the fluid compartments across the three groups. Specifically, Group 2 and 3 exhibited significantly higher APTw values (3.80% and 1.85%, respectively) compared to Group 1 (1.00%, P < 0.05). After fluid suppression, a marked decrease in FS-APTw values was observed in the fluid compartments of all three groups, as compared to their respective APTw values (P < 0.05 for all). Notably, the most pronounced reduction in APTw value was discerned in Group 2 (-1.23%).Conclusions FS-APTw can effectively suppress the APTw signals of fluid components in post-treatment gliomas, while maintaining the signals of solid tissues. This fluid suppression effect was particularly pronounced in fluid compartments with protein-rich liquid, shown as equal or high signal intensities on FLAIR and low on DWI.
[Keywords] glioma；fluid suppression；fluid components；amide proton transfer weighted imaging；magnetic resonance imaging

HOU Jingwen1   ZHANG Chi1   SU Chunqiu1   ZHAO Xiance2   CAO Yuandong3   LU Shanshan1*  

1 Department of Radiology, the First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China

2 Philips (China) Investment Company, Shanghai 200042, China

3 Department of Radiation Oncology, the First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China

Corresponding author: LU S S, E-mail: shanshanlu@njmu.edu.cn

Conflicts of interest   None.

Received  2025-03-27
Accepted  2025-08-08
DOI: 10.12015/issn.1674-8034.2025.09.007
Cite this article as: HOU J W, ZHANG C, SU C Q, et al. The feasibility of fluid-suppressed amide proton transfer-weighted imaging in suppressing the fluid components of post-treatment gliomas[J]. Chin J Magn Reson Imaging, 2025, 16(9): 40-45. DOI:10.12015/issn.1674-8034.2025.09.007.

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