Fig. 3
A 63-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 site of previously resected glioblastoma which had increased from prior scans. B T2-FLAIR images demonstrate associated hyperintense signal abnormality surrounding the lesion. C DSC-PWI shows mildly elevated rCBV from the enhancing region of the tumor. Overall constellation of these conventional and advanced imaging findings was concerning for true progression. Multiparametric MRI based prediction model comprising rCBVmax with FA D and CL E revealed a diagnosis of PsP (rCBVmax = 2.61, FA = 0.13, CL = 0.05), suggesting a significant component of treatment-related changes (PP = 19%). F The hematoxylin and eosin stained sections show infarct, abundant macrophages, and hyalinized vessels, indicative of treatment-related changes