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. 2022 Jan 27;4(1):vdac006. doi: 10.1093/noajnl/vdac006

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© The Author(s) 2022. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

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Figure 4. — Examples of 2 cases with “late pseudoprogression” or radiation necrosis are shown. Case 1 (A) At 1-month post-RT, residual enhancement is seen on T1w MRI within the pink PTV3 contour. (B) At 5-month post-RT, residual enhancement has increased, but the relative cerebral blood volume (rCBV) map on dynamic susceptibility contrast (DSC) perfusion MRI shows minimal to no perfusion. (C) Repeat resection demonstrated 100% necrosis on H&E-stained sections. Case 2 (D) At 1-month post-RT, there is primarily linear, postoperative enhancement on T1w-CE MRI within the red PTV3 contour. (E) At 8-month post-RT, increasing enhancement is seen at the periphery of the cavity. The DSC perfusion MRI again shows no definitive hyperperfusion. (F) Repeat resection again found predominantly (99%) necrosis on H&E-stained sections.