FIG 1. Patient 7.

A–D, Serial contrast-enhanced gradient-echo images (2/6/1) and PRESS spectra (1000/144/1; voxel resolution, 1.0 cm³) acquired 1 day (A), 3 months (B), 5 months (C), and 6 months (D) after gamma knife treatment and aligned retrospectively. The 15-Gy isodose line is shown in red. The volume of contrast enhancement is significantly reduced at the 3-month time point, but increases at both the 5- and 6-month follow-ups. Reduction of Cho from baseline levels is apparent at the 3-, 5-, and 6-month time points. No significant change in NAA levels is observed, while a lactate/lipid resonance develops at 3 to 5 months but is reduced at 6 months. This patient received no further treatment and died 17 months after undergoing gamma knife radiosurgery.