Findings:

On the CT and Thallium brain images (27k bytes), the most cranial aspect of the ring enhancement (arrow, 27k bytes) was thicker and showed increased Thallium activity (thin arrow) correlating with tumor recurrence. In addition, there was associated increased perfusion about the margins of the surgical site with a large central region of hypoperfusion corresponding to the known post-operative fluid collection.

Thallium and HMPAO perfusion brain scans (95k bytes) are shown together. The site of tumor recurrence (thin arrow, 95k bytes) is again seen. There is a large area of decreased perfusion in the left supratentorial surgical bed (arrow heads). There was decreased perfusion to the contralateral (right) cerebellum (arrow). The cerebellum showed no abnormalities on the previous CT and MRI examinations.

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J. Anthony Parker, MD PhD, Tony_Parker@bih.harvard.edu