There is a need to determine clinical markers that can distinguish between pseudoprogression (PsP) and true progression after patients with GBM undergo resection followed by chemoradiation. We conducted a retrospective study of collected magnetic resonance spectroscopic imaging (MRSI) and perfusion weighted imaging (PWI) data with the aim of investigating their utility in predicting tumor progression. Within the enhancing region on post-contrast T1 imaging, patients with true progression have decreased myo-Inositol normalized by contralateral creatinine (mI/c-Cr), elevated lactate normalized to glutamate+glutamine (Lac/Glx), and elevated relative cerebral blood flow (rCBF) relative to those with PsP.
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