The value of intra-voxel incoherent motion, susceptibility-weighted images and post-contrast magnetic resonance perfusion studies in assessment of treatment response to brain tumor

Abstract Background Our aim to assess the significance of new multi-parametric MRI techniques as intra-voxel incoherent motion (IVIM), T2* perfusion, T1 permeability and susceptibility-weighted images (SWI) in differentiating from recurrent tumor from post treatment changes. Results Forty-five patients were enrolled in the current study, 25 patients with recurrence and 20 with radiation necrosis. As regard the IVIM parameters, the perfusion fraction (f) and the pseudodiffusion (D*) component shows significant difference between radiation changes and recurrent tumor ( P value = 0.01). The Ktrans showed significant difference between radiation changes and recurrent tumor ( P value = 0.001). The proportion of dark signal intensity on susceptibility-weighted imaging (proSWI) showed significant difference between radiation changes and recurrent tumor ( P value = 0.0001), while the diffusion component (D) showed no significant difference between radiation changes and recurrent tumor ( P value = 0.282). Conclusions Multi-parametric new techniques as intra-voxel incoherent motion, susceptibility weighted images and post-contrast perfusion studies allow early and accurate differentiation of recurrent tumor from post radiation changes and thus improving the patients overall clinical outcome.