Despite previous research on physiological and metabolic MR imaging techniques with standard clinical anatomical MRI of patients with recurrent glioma, there is still no one parameter that can differentiate recurrent glioblastoma (rGBM) from treatment-induced effects (TxE) with high enough accuracy to be used clinically. We assessed the value of incorporating anatomical, perfusion-weighted, diffusion-weighted, and spectroscopic imaging parameters to identify TxE in patients suspected of rGBM. nPH from DSC perfusion-weighted imaging and Choline-to-NAA Index from MR spectroscopic imaging were found to be the most related to pathological markers of tumor and TxE.
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