Figure 1.

Typical imaging appearance of glioblastoma in a 12 year old male subject. Axial T2-weighted (A) and fluid attenuated inversion recovery (FLAIR) (B) images demonstrate a heterogeneously T2 hyperintense tumor centered at the left occipital lobe with extensive peritumoral edema (arrow). Axial post contrast T1 weighted imaging demonstrating classic heterogenous, rim enhancing lesion (C). The color coded fractional anisotropy image (D) through the tumor demonstrates distrupted brain architecture at the necrotic tumor core (*). The left inferior longitudinal fasciculus is thinned out and displaced due to the mass effect of the tumor. The arrowheads at the tumor periphery demonstrate low intensity compared to the contralateral hemisphere suggesting, lower FA values. Cerebral blood flow (CBF) from 3D PCASL arterial spin labelling perfusion imaging (E) demonstrates high blood flow at the peripheral enhancing component of the tumor (arrows). The single voxel MR spectroscopy (F) demonstrates severely truncated choline (arrow) and N-Acetyl Aspartate (NAA) peaks (arrowhead) as well as a dominant lipid/lactate peak. This is a typical imaging feature when a spectroscopy voxel includes both tumor and necrotic tissue.