Figure 3.

Following apparent gross total resection (contrast-enhanced MRI, far left), residual tumor is demonstrated adjacent to the superior and inferior portions of the cavity. The superior residual consists of hyperperfused (orange arrow, top 2^nd panel) and a small volume of hypercellular tumor (red arrow, top 3^rd panel), concordant with a region of metabolic abnormality detected using ¹¹C-Methionine PET (top 4^th panel). The inferior residual consists of predominantly hypercellular (red arrow, bottom 3^rd panel) and some hyperperfused tumor (orange arrow, bottom 2^nd panel), without associated metabolic abnormality (bottom 4^th panel). Pathologically confirmed central tumor recurrence was concordant with all 3 advanced imaging tumor volumes superiorly (red and blue, upper far right panel) and the hypercellular/hyperperfused tumor inferiorly (red, bottom far right panel). Gd=Gadolinium; CBV=Cerebral blood volume; MET-PET=Methionine Positron Emission Tomography