Diffusion Weighted Imaging in Neuro-Oncology: Diagnosis, Post-Treatment Changes, and Advanced Sequences—An Updated Review

SIMPLE SUMMARY: Differential diagnosis among primary and secondary central nervous system tumors, the assessment of tumoral therapy response, the correlation between imaging and prognosis, and biomolecular findings remain the main diagnostic challenges in the neuro-oncology imaging field. In the literature, novel, sophisticated MRI sequences and applications of artificial intelligence are frequently researched with this goal in mind; anyway, some of these tools are still not applicable in clinical practice. On the contrary, Diffusion Weighted Imaging (DWI) is a sequence commonly used in everyday clinical practice that can give information in terms of tumor grading, differential diagnosis, molecular profile, and response to therapy. ABSTRACT: DWI is an imaging technique commonly used for the assessment of acute ischemia, inflammatory disorders, and CNS neoplasia. It has several benefits since it is a quick, easily replicable sequence that is widely used on many standard scanners. In addition to its normal clinical purpose, DWI offers crucial functional and physiological information regarding brain neoplasia and the surrounding milieu. A narrative review of the literature was conducted based on the PubMed database with the purpose of investigating the potential role of DWI in the neuro-oncology field. A total of 179 articles were included in the study.