脑胶质母细胞瘤患者（GBM）的治疗非常复杂，涉及实施标准治疗，包括切除手术，放射治疗和化疗，以及通过临床试验和精准医疗方法进行新型免疫治疗和靶向小分子抑制剂治疗。随着治疗的进步，GBM患者的放射学和临床评估变得更加具有挑战性和细致。磁共振成像的空间分辨率和解剖生理信息的提高极大地改善了治疗前、治疗过程中和治疗后GBM的非侵入性评估。识别为伪进展（PsP），定义为看起来像是肿瘤进展的变化，实际上是暂时性的，并与治疗反应有关，对于成功的患者管理至关重要。这些暂时性的变化可能会产生由于肿瘤质量和水肿而产生的新临床症状。将这种实体与真正的肿瘤进展区分开来是患者管理和预后的主要决策点。提供者可以选择开始另一种疗法，转换到临床试验，考虑重复切除，或继续当前的治疗以期解决问题。在这篇综述中，作者描述了神经外科医生需要注意的侵入性和非侵入性技术，以识别PsP并促进手术决策。

Management of patients with glioblastoma (GBM) is complex and involves implementing standard therapies including resection, radiation therapy, and chemotherapy, as well as novel immunotherapies and targeted small-molecule inhibitors through clinical trials and precision medicine approaches. As treatments have advanced, the radiological and clinical assessment of patients with GBM has become even more challenging and nuanced. Advances in spatial resolution and both anatomical and physiological information that can be derived from MRI have greatly improved the noninvasive assessment of GBM before, during, and after therapy. Identification of pseudoprogression (PsP), defined as changes concerning for tumor progression that are, in fact, transient and related to treatment response, is critical for successful patient management. These temporary changes can produce new clinical symptoms due to mass effect and edema. Differentiating this entity from true tumor progression is a major decision point in the patient's management and prognosis. Providers may choose to start an alternative therapy, transition to a clinical trial, consider repeat resection, or continue with the current therapy in hopes of resolution. In this review, the authors describe the invasive and noninvasive techniques neurosurgeons need to be aware of to identify PsP and facilitate surgical decision-making.