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. 2023 Mar 13;57(6):1676–1695. doi: 10.1002/jmri.28663

FIGURE 3.

FIGURE 3

Example of an astrocytoma, IDH‐mutant, 1p/19q retained, CNS WHO grade 4. The structural images (a: T1w, b: T1w post‐Gd, c: T2w, d: FLAIR) demonstrate a heterogeneous lesion with a rather solid central and well‐enhancing part and a peripheral compartment demonstrating some T2/FLAIR mismatch without overt enhancement. The APT‐weighted maps (e: standard APT CEST, f: fluid‐suppressed APT CEST;Source: Casagranda S et al. ISMRM 29th An Meet 2021) show significantly elevated signal in the enhancing tumor, suggesting clearly high‐grade features. Notably, the rim zone of the lesion shows variable degrees of APTw signal elevation in the fluid‐suppressed images, thus suggesting that this compartment features mixed solid and cystic parts. Interestingly, the anterior rim zone, along with a halo surrounding the enhancing area, demonstrates a mildly elevated APTw signal that indicates likely high‐grade metabolic tumor characteristics. The data were acquired on a Siemens 3 T Prisma scanner. APTw protocol included DC = 91%, B1rms = 2uT, Tsat = 2 s, and WASAB1 for B0 correction. WASAB1 and APTw data were processed in Olea Sphere 3.0 software (Olea Medical, La Ciotat, France).