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. 2023 Sep 13;5(1):vdad118. doi: 10.1093/noajnl/vdad118

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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 2. — Treatment-related radiographic changes. (A) Pseudoprogression in a 50-year-old IDH wild-type diffuse midline glioma patient before initiating Pembrolizumab showing axial FLAIR (i) and T1 postcontrast (iv) images. Twenty days after Pembrolizumab therapy, there is an increase in vasogenic edema on axial FLAIR (ii) and contrast enhancement on T1 postcontrast (v) concerning for true progression versus pseudoprogression. Two months after Pembrolizumab therapy, there is a significant decrease in FLAIR hyperintensity (iii) and contrast enhancement (vi) confirming the previous diagnosis as pseudoprogression. (B) Pseudoresponse in a 55-year-old IDH wild-type glioblastoma patient before initiating bevacizumab (Avastin) showing axial FLAIR (i) and T1 postcontrast (ii) images. Two months after Avastin therapy, FLAIR hyperintensity and mass effect are unchanged (iii), but there was interval decrease in tumor enhancement on T1 postcontrast (iv).