The role of DWI in postoperative high grade glioma trials

Although DWI is recommended by RANO working group in the immediate postoperative MRI scan in determining whether new enhancement developing in the subsequent weeks is caused by ischemia or by tumor recurrence, DWI is not currently endorsed for differentiating treatment effect from recurrent tumor due to lack of sufficient specificity. Because changes in tumor water diffusivity can occur secondarily to changes in cell density, DWI might also be a maker for response to therapy and an early predictor of therapeutic efficacy. The roles of DWI in patients with postoperative HGG trial are reviewed along with imaging examples.

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