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. Author manuscript; available in PMC: 2020 May 1.
Published in final edited form as: J Neurooncol. 2019 Mar 19;143(1):157–166. doi: 10.1007/s11060-019-03152-9

Fig. 4.

Fig. 4.

Left temporal glioblastoma. (A) T1c MRI with submitted GTV2 (cavity plus enhancement) contours. (B) shows CTV_6000 contour variation at the interface of the brainstem and temporal lobe while (C) shows the averaged GTV2 volume (pink) with consensus CTV_6000 contour (purple) extending into contiguous brainstem. (D) T2-FLAIR MRI with GTV1 (FLAIR) contours. (E) CTV_4600 contours with significant variation at the interface of the brainstem and temporal lobe. The averaged GTV1 (FLAIR) contour is the smallest volume in red. (F) shows averaged GTV2 (pink=cavity plus enhancement) and GTV1 (red=FLAIR) volumes in axial T1c scans. The blue contour was the STAPLE CTV_4600 [averaged from contours in (E)], whereas the orange is the consensus CTV_4600, altered from the STAPLE CTV_4600 to include the contiguous brainstem (hash) but trimmed from the averaged CTV1 contour at the pre-pontine and quadrigeminal cisterns (asterisks). (G, H) shows average GTV2 (pink=cavity plus enhancement) and GTV1 (red=FLAIR) volumes (not present at midline on sagittal plane). CTV1 expansion (without anatomic trimming) in green. The space between the green and orange consensus CTV_4600 contour reflects anatomic trimming off the cerebellum (white arrow) due to cerebellar falx. Note the inclusion of brainstem in direct anatomic contiguity via the cerebral peduncle.