Approximately 4 months post surgery, after radiotherapy has finished, there intense peripheral enhancement and florid vasogenic oedema around the lesion. The enhancing component demonstrates only minor elevation of cerebral blood volume (rCBV) and only thin reduction of ADC values, difficult to interpret due to the presence of blood products best seen on SWI. MRS (not shown) was equivocal dominated by lipid-lactate peak.
It was felt that most of the findings were compatible with pseudoprogression rather than true progression.