Figure 4
From: Apparent diffusion coefficient as a prognostic factor in clival chordoma
A 37-year-old man was diagnosed with classic chordoma and placed in the aggressive group. (a) Preoperative contrast enhanced T1-weighted imaging showed a tumor compressing the brainstem. (b) The ROI is outlined in yellow on the ADC map and represents decreased water diffusivity (mean ADC 1107 × 10–6 mm2/s, minimum ADC 877 × 10–6 mm2/s). (c) Immediate postoperative contrast enhanced T1-weighted imaging shows gross total removal. Surgery was performed via the far lateral transcondylar approach. The patient received proton-based radiotherapy 3 months after surgery. (d) Contrast-enhanced T1 weighted imaging obtained 2 years later showed an increase of the mass adjacent to the previous surgical site. The patient died of disease 7 months after the last MRI due to meningitis.
