Purpose: Since the researcher has observed the amide proton transfer (APT) imaging signal intensity varied with the Choline signal intensity detected by multi-voxelmagnetic resonance spectroscopy (MRSI) in a patient of anaplastic astrocytoma (Grade Ⅲ), this prospective study was designed to explore whether the asymmetric magnetic transfer ratio (MTRasym) based on APT imaging represents the tumor proliferation. Materials and Methods:This prospective research was approved by the Hospital Ethics Committee. A total of 42 patients were enrolled in this study, and all of them had tumor resection. According to WHO criteria, 28 were with low grade glioma, 14 with high grade glioma (grade Ⅲ 6, grade IV 8). Four circular ROIs were drawn by two readers who were blinded to patients histopathology, the mean MTRasym signals were compared among low- and high-grade gliomas and their correlations with ki-67 were analyzed. To determine the relationship between MTRasym and the multiple parameters including Cho, NAA and Cho/NAA obtained by MRSI, 36 patients were included in the Voxel-by-voxel analysis. The receiver operating characteristic curve (ROC) was employed to determine the diagnostic performance. The correlation coefficient and intraclass correlation coefficients were analyzed. Results: The MTRasym of low-grade gliomas was significantly smaller than that in high-grade gliomas (2.65±0.20 vs 3.74±0.17, P = 0.001 for reader 1; 2.63±0.18vs 3.47±0.16, P =0.004 for reader 2) with a sensitivity of 92.9% and a specificity of 71.4%. The correlation analysis between the APT MTRasym value of tumor solid parts and Ki-67 Labeling Index revealed a moderate positive correlation (r=0.449, p=0.005). Among all the patients, the APT MTRasym value of the solid parts of tumor moderately correlated positively with the magnitude of Cho (r = 0.429, P =0.009) and the Cho/NAA Ratio (r = 0.423, P =0.01), but negatively with the magnitude of NAA (r = -0.455, P =0.005), espectively. Analysis of low grade gliomas revealed that the MTRasym showed a similar correlation tendency with Cho, NAA and the Cho/NAA ratio (r = 0.442, P =0 .031 VS r =-0.474, P =0.019 VS r = 0.448, P =0 .028, respectively), while the absolute value of correlation coefficient of high-grade gliomas were higher (r = 0.547, P =0 .053; r = -0.644, P =0 .017; r=0.583, p=0.036, respectively). Conclusion: The asymmetric APT imaging may serve as a non-invasive biomarker for tumor proliferation and reflect the secondary tumor derived neuronal damages.