Fig. 4

A 49-year-old clinically-stable male patient with bi-frontal grade IV glioblastoma multiforme finished chemoradiotherapy 7 months ago. a and b Axial FLAIR images of the first and second studies, respectively show an increase of the FLAIR component by less than 25%. No changes in the surrounding mass effect. c and d Axial post-contrast T1 WIs of the first and second studies, respectively show an increase in the enhancing component by less than 25% in the follow-up study. e and f Axial DWI and g and h Axial ADC maps show a decrease of ADCmean in the enhancing resection cavity margin (1.3 × 10⁻³mm²/s) and (0.99 × 10⁻³mm²/s) in the first and second studies, respectively. BT-RADS category 3b was given with an intermediate probability of tumor recurrence. Decrease ADCmean favor the possibility of tumor recurrence. Tumor progression was proved in the second stage follow-up study