Serial magnetic resonance imaging scans with gadolinium including T2-weighted (top) and fluid-attenuated inversion recovery sequences (bottom) shown during the treatment schedule. The treatment time points, relative to neoadjuvant ICI therapy initiation (day +1) are shown, including ICI cycles (blue), radiotherapy (green) and peptide vaccine doses (yellow). The peptide vaccine program was recently completed, and ongoing analyses will be reported separately. The most recent scan (day +526) demonstrated grossly stable postsurgical changes with persistent white matter T2 fluid-attenuated inversion recovery hyperintensity in the left temporal periventricular white matter posterior to the temporal pole surgical bed and the left temporal operculum. There was a stable small focus of enhancement lateral to the left temporal horn. These changes were all within the high-dose radiotherapy field. No focal hyperperfusion or diffusion restriction to suggest recurrent disease was observed.
