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. 2023 Jun 15;5(1):vdad074. doi: 10.1093/noajnl/vdad074

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© The Author(s) 2023. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

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Figure 1. — Axial MPRAGE and T2/FLAIR sequences demonstrating the 5^th (first column) and 6^th (second column) progression after surgery and salvage systemic therapies with significant progression of disease and surrounding mass effect in the right temporal lobe. Temporally modulated pulsed proton re-irradiation (TMPPR) isodose distribution included coverage of the contrast-enhancing tumor and surrounding T2/FLAIR signal (third column). First follow-up MRI performed, 4 weeks after completion of TMPPR demonstrated a complete radiographic response to treatment (fourth column).