Figure 1.

Twenty-two-year-old female, previously treated for an anaplastic astrocytoma at New York University Langone Medical Center, started on bevacizumab (BEV) 6 months after the initial diagnosis for a progressive recurrent tumor. Baseline imaging before BEV treatment: axial flair (A), axial view after contrast (B), and DSC T2*cerebral blood volume parametric maps (C) showing a large, recurrent, heterogeneously enhancing glioblastoma with surrounding edema and mass effect, as well as markedly increased blood volume. Four weeks after BEV treatment: axial flair (D), axial view after contrast (E), and dynamic susceptibility contrast (DSC) T2*cerebral blood volume parametric maps (F) showing slight improvement in the size and degree of enhancement of the large heterogenous tumor, with slight improvement in the swelling and edema. Remarkably, cerebral blood volume maps show reduction in tumor blood volume, suggestive of typical initial response seen with antiangiogenic therapy.