Legend Ax T2W: left temporal resection cavity with surrounding signal hyperintensity in the occipital, temporal, and subinsular white matter and posterior limb of internal capsule. FLAIR T2W: irregularity and heterogeneity of signal at the margins of the resection cavity.

Legend Cor/Ax T1W: Heterogeneous signal just inferior to the resection cavity. Post gadolinium, thin, smooth enhancement is seen around the superior cavity, with thick, irregular, enhancement around the heterogeneous signal inferior to the cavity.

Legend Proton Spectroscopy: Anterior voxel shows high lipid/lactate peak, with uniformly decreased NAA, creatine, and choline. Posterior voxel shows increased lipid/lactate, but also high choline relative to creatine and NAA.

Legend Ax/Cor T1W: The resection cavity has decreased in size; nodular enhancement is seen posterior and superior to the resection cavity.

Legend Single and Multivoxel Proton Spectroscopy: Voxel over the nodular enhancement shows marked increase of choline relative to creatine and NAA; multivoxel analysis shows that the abnormal choline levels extend medially beyond the margins of the enhancing abnormality. Key words: mri mrs tumor neoplasia

Brain Diagnosis: Recurrent glioblastoma