Potential Utility of Early Post-Operative Diffusion-Weighted Imaging and Perfusion Weighted Imaging in Differentiating Between Pseudo-Progression and Progression in Patients with Glioblastoma Treated with Temozolomide and Radiotherapy

Xiang Liu¹, Wei Tian¹, Henry Wang¹, Sven Ekholm¹

Standard chemo-radiation therapy with temozolomide may induce pseudo-progression in 20-50% patients with glioblastomas, which resembles true tumor progression on conventional MRI. We reviewed sequential MRI examinations in 41 patients with new diagnosed glioblastoma, our preliminary result showed that increased rCBV value in the early post-operative PWI examinations may be useful in differentiating pseudoprogression and tumor progression in such patients within 6 months after radiation/ temozolomide treatment. Early post-operative restricted diffusion has limited potential value in distinguishing pseudo-progression from tumor progression