Figure 2.
The patient was a 43 yo male with grade 2 gemistocytic astrocytoma of the right temporal lobe treated on a clinical protocol with definitive radiation to 59.4 Gy and adjuvant temozolomide who remained without disease progression at last follow-up. Top panel shows pre-RT T2/FLAIR MRI (left) and overlying radiation dose distribution (right). Middle panel shows fractional anisotropy (FA) maps, a measure of anisotropic diffusion that reflects overall white matter fiber integrity, pre-RT (left) and 18 months post-RT (right). Bottom panel shows an enlarged view of the area within the white boxes; right and left cingulum outlined in white. FA declined by 30% in the right cingulum, and by 1% in the left. The patient experienced a significant decline of 5 standard deviations in delayed recall at 18 months compared to pre-RT.
