Glioma, an aggressive brain malignancy characterized by rapid progression and its poor prognosis, poses significant challenges for accurate evolution prediction. These challenges are exacerbated by sparse, irregularly acquired longitudinal MRI data in clinical practice, where incomplete follow-up sequences create data imbalances and make reliable modeling difficult. In this paper, we present a multitask diffusion framework for time-agnostic, pixel-wise prediction of glioma progression. The model simultaneously generates future FLAIR sequences at any chosen time point and estimates spatial probabilistic tumor evolution maps derived using signed distance fields (SDFs), allowing uncertainty quantification. To capture temporal dynamics of tumor evolution across arbitrary intervals, we integrate a pretrained deformation module that models inter-scan changes using deformation fields. Regarding the common clinical limitation of data scarcity, we implement a targeted augmentation pipeline that synthesizes complete sequences of three follow-up scans and imputes missing MRI modalities from available patient studies, improving the stability and accuracy of predictive models. Based on merely two follow-up scans at earlier timepoints, our framework produces flexible time-depending probability maps, enabling clinicians to interrogate tumor progression risks at any future temporal milestone. We further introduce a radiotherapy-weighted focal loss term that leverages radiation dose maps, as these highlight regions of greater clinical importance during model training. The proposed method was trained on a public dataset and evaluated on an internal private dataset, achieving promising results in both cases
Kebaili et al. (Sat,) studied this question.