FIGURE 1.

Pathologically proven radionecrosis in a 45 years old woman with anaplastic pleomorphic xanthoastrocytoma treated with Stupp protocol (radiotherapy and concurrent chemotherapy with temozolomide). Axial 3D T₁w spin echo before (a) and after (b) gadolinium injection showed a contrast-enhancing intra-axial frontal lesion, with some hemorrhagic remnants that were spontaneously bright on T₁w. This lesion was surrounded by a large nonenhancing FLAIR hyperintensity, visible on axial 3D FLAIR (c) and it was characterized by a strong diffusion restriction (d: axial diffusion with b100 value, e: ADC cartography). No hyperperfusion was seen [f: axial arterial spin labelling (ASL) perfusion]. This radio-induced lesion developed 2 months after the end of radiotherapy. ADC, apparent diffusion coefficient.