Fig. 2
A 61-year-old male patient with glioblastoma, status post gross total resection and chemoradiation. A Post-contrast T1-weighted image shows a heterogeneously enhancing lesion at the site of previously resected glioblastoma, which had increased from prior scans. B T2-FLAIR image demonstrates hyperintense signal abnormality surrounding the lesion. C DSC-PWI shows elevated rCBV from the posterior enhancing region of the tumor (white arrows). Overall the constellation of these conventional and advanced imaging findings was concerning for true progression. Multiparametric MRI based prediction model comprising rCBVmax, FA D, and CL E revealed a diagnosis of TP+mixed tumor (rCBVmax = 7.93, FA = 0.15, CL = 0.05), suggesting a significant component of recurrent tumor (PP = 84%). F The hematoxylin and eosin stained sections demonstrate hypercellular tissue representative of tumor with hyperchromatic irregular nuclei, and minimal treatment-related changes