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FIG 2. Patient 2: 48-year-old woman with a history of a glioblastoma multiforme treated with surgery, external beam radiation (59 Gy), and interstitial brachytherapy (58 Gy).
A, Axial T1-weighted MR image reveals enhancement of a right frontal lobe/insular lesion that has both solid and cavitary components. The spectroscopy voxel includes the medial margin of enhancement.
B, MR spectrum shows a prominent lipid/lactate peak with minimal residual Cho and Cr; NAA is absent. The pattern was thought to be consistent with radiation necrosis, and this diagnosis was confirmed at resection. This patient had subsequent follow-up spectroscopy studies at 1, 3, and 4 months that were unchanged (not shown).
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