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Images in a 59-year-old woman with nonenhancing infiltrative grade III glioma in the right frontal lobe with a highly elevated Lac level and increased rCBV before surgery: post-contrast T1-weighted image with an overlying PRESS box and voxel grid (A); difference spectra showing huge, elevated Lac peaks (B); Lac image overlaid on the post-contrast T1-weighted image (C), and rCBV (color) overlaid on the post-contrast T1-weighted image (D). White = PRESS box, blue = Lac contour.
