MRI in Glioma Immunotherapy: Evidence, Pitfalls, and Perspectives

Figure 3

MRS during immunotherapy, after surgery, and radiotherapy plus temozolomide. Left, spectra; right, voxel positioned within enhancing lesions. (a) High Cho and low NAA with minimum lipids in recurrent glioma. (b) Preserved Cho and NAA levels with evident though not prevalent lipid peak in pseudoprogression (the same case is shown in Figure 1—time point Oct 2014). (c) Prominent peak of lipids and lower peaks of Cho, Cr, and NAA but with high Cho/Cr and Cho/NAA ratios in mixed scenario with glioma recurrence and radionecrosis.

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