Application of MRI histogram analysis based on non-Gaussian diffusion model in distinguishing recurrence from pseudoprogression

Motivation: Glioblastoma's aggressive recurrence and conventional MRI limitations in pseudoprogression discrimination drove our assessment of non-Gaussian diffusion biomarkers for personalized surgical/adjuvant therapy planning. Goal(s): A reliable method for distinguishing between recurrence and pseudoprogression in Glioblastoma patients (9009). Approach: This prospective study analyzed 55 biopsy-proven glioblastoma cases. Automated segmentation of preoperative and recurrence-phase MRI delineated tumor/edema regions. Non-Gaussian diffusion-derived histogram metrics compared recurrence-associated versus non-recurrent peritumoral edema subregions Results: Recurrence regions exhibited statistically significant differences (p<0.05) in histogram parameters compared to non-recurrence regions, highlighting the clinical utility of non-Gaussian diffusion models in identifying occult tumor infiltration Impact: Non-Gaussian diffusion MRI detects occult tumor infiltration in peritumoral edema (invisible on conventional MRI), enhancing recurrence/pseudoprogression prediction to optimize GBM surgical and adjuvant therapy.