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  Indian J Med Microbiol
 

Figure 5: Patient 12 was a 78-year-old male presented with memory loss, MRI showed well-defined lesion in the left parietal region (arrows), periventricular location, (a) hyperintense on T2 with edema, (b) T1-postcontrast showed minimal enhancement, (c and d) rim of restricted diffusion and low apparent diffusion coefficient, (e) MR spectroscopy showed choline peak with raised Cho/Cr ratio, and MR perfusion imaging showed relative cerebral blood volume of 158.3 suggestive of mild hyperperfusion. Considering the age and overlapping imaging features, differentials of PCNSL, metastases, and high-grade glioma were given. FET-PET showed intense uptake in lesion on axial PET (f) and fused PET/CT (g) images with tumor-to-contralateral white mater (T/Wm) ratio of 2.4 and 2.5 at 5 and 20 min, favoring high-grade glioma. Histopathology was WHO Grade IV glioma – glioblastoma

Figure 5: Patient 12 was a 78-year-old male presented with memory loss, MRI showed well-defined lesion in the left parietal region (arrows), periventricular location, (a) hyperintense on T2 with edema, (b) T1-postcontrast showed minimal enhancement, (c and d) rim of restricted diffusion and low apparent diffusion coefficient, (e) MR spectroscopy showed choline peak with raised Cho/Cr ratio, and MR perfusion imaging showed relative cerebral blood volume of 158.3 suggestive of mild hyperperfusion. Considering the age and overlapping imaging features, differentials of PCNSL, metastases, and high-grade glioma were given. FET-PET showed intense uptake in lesion on axial PET (f) and fused PET/CT (g) images with tumor-to-contralateral white mater (T/Wm) ratio of 2.4 and 2.5 at 5 and 20 min, favoring high-grade glioma. Histopathology was WHO Grade IV glioma – glioblastoma