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Fig. 1B 62-year-old man with glioblastoma multiforme. Depiction of
changes in leakage of contrast material (a reflection of degree of
permeability across blood-brain barrier) after administration of
antiangiogenic agent directed against vascular endothelial growth factor
(VEGF) receptor tyrosine kinase. Series of images shows additional physiologic
information provided by dynamic imaging relative to solely anatomic
information provided by conventional MRI. Because imaging findings solely
reflect effect of angiogenesis (i.e., permeability), this technique is an
example of indirect imaging of angiogenesis. Color-coded map derived from
dynamic contrast-enhanced imaging sequence before therapy (corresponding to
A) shows degrees of contrast enhancement (changes in signal intensity)
normalized against signal intensity in normal tissue. Color-coded map
indicates relative degrees of permeability in each pixel, with blue pixels
representing signal intensity that is 120-149% of normal tissue, green pixels
representing 140-159% of normal tissue, and red pixels representing > 160%
of normal tissue. Note that most pixels are in > 160% range, indicating
marked leakage of contrast material.