To evaluate the diagnostic performance of DKI in differentiating glioma recurrence from pseudoprogression and the combined value of DKI and DSC MRI parameters. Tumor recurrence was confirmed to be associated with more tumor angiogenesis, greater nuclear atypia, and increased cell density, whereas pseudoprogression is characterized by radiation-induced vascular changes leading to vasodilation, edema, and increased capillary permeability. These resulted in a more complex structure of recurrent tumor than pseudoprogression. It is concluded DKI and DSC MRI may serve as imaging biomarker of treatment response by characterizing the heterogeneity of the microenvironment and newly formed immature blood vessels.
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