Fig 1.

Magnetic resonance imaging (MRI) results in a responding patient (patient 11), with transient pseudoprogression. In each panel, sagittal T1-weighted gadolinium-enhanced images are on the left, and axial fluid-attenuated inversion recovery images are on the right. (A) MRI scan at diagnosis. (B) MRI scan before vaccine therapy (3 months after diagnosis and start of irradiation). Tumor is unchanged from baseline. (C) Four months after the start of vaccination, the patient had tumor enlargement, increased enhancement, and symptomatic worsening. High-dose dexamethasone was started. (D) The MRI scan shows dramatic reduction of enhancement and mass effect 1 month later (1/16/11). Dexamethasone was weaned, and vaccination was subsequently resumed. The partial response status was then maintained until 18 months after diagnosis.