PMC10159314_01
Representative magnetic resonance imaging of the tumor at varying time points. (a) Contrasted T1 images before resection (b) Contrasted T1 image post-resection, pre- intensity-modulated radiation therapy (c) T1 (left) and T2 (right) images post-stereotactic radiosurgery, pre-laser interstitial thermal therapy (LITT). (d) The chosen supraorbital biopsy/LITT tract terminating anterior to the middle cerebral artery is shown (clockwise from top right) in axial, coronal, and sagittal views in neuronavigation software. (e) Post-LITT fluid attenuated inversion recovery imaging intraoperatively (day of surgery, DOS) and at 2 months (2 mo), 6 months (6 mo), and 10 months (10 mo), respectively.
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F1
Initial imaging is shown in Figure 1a. Six-week postoperative MRI revealed 2.3 x 2.7 cm of residual enhancing tumor along the left sphenoid wing as expected [Figure 1b]. Unfortunately, postradiation MRI [9 months total postoperative, Figure 1c] showed increased tumor size to 3 cm in maximal diameter and contrast enhancement along the sphenoid wing with possible bone infiltration. Special caution was taken to create a trajectory sparing the cranial nerves and other eloquent structures, as shown in neuronavigation software [Figure 1d]. Follow-up MRIs have been stable, and the patient has remained progression free at 24 months post-LITT [Figure 1e].