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Jacob S. Young, Andrew J. Gogos, Matheus P. Pereira, Ramin A. Morshed, Jing Li, Matthew J. Barkovich, Shawn L. Hervey-Jumper, and Mitchel S. Berger

the contrast-enhancing lesion contacted the cortex. Patterns of recurrence were evaluated and considered to involve remote sites if the recurrent contrast-enhancing tumor was not contiguous with the resection cavity or residual tumor. To be considered a tumor with subependymal disease, there must have been significant enhancement or enhancing nodularity of the ventricular lining extending beyond mere contact with the ventricle, and as such not every SVZ type I and II tumor was considered positive for subependymal disease ( Fig. 2 ). The extent of nonenhancing FLAIR

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J. Paul Elliott, G. Evren Keles, Michael Waite, Nancy Temkin, and Mitchel S. Berger

ventricle. Upper Right: Postoperative image confirming ventricular entry. Lower Left: Image revealing first evidence of subependymal dissemination 6 months following surgery with ventricular entry. Lower Right: Follow-up image 7 months postoperatively showing progressive subependymal disease. Fig. 2. Graphs showing cerebrospinal fluid (CSF) tumor dissemination. Kaplan-Meier curves demonstrate no significant effect on CSF tumor dissemination for ventricular entry during surgery (upper left) , tumor location contiguous to the ventricular system (upper

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Michael A. Vogelbaum, Cathy Brewer, Gene H. Barnett, Alireza M. Mohammadi, David M. Peereboom, Manmeet S. Ahluwalia, and Shenqiang Gao

also required to be at least 18 years of age and have a KPS of 70–100. The volume of the enhancing component of the recurrent tumor was required to be less than 40 cm 3 and patients were required to have laboratory values permissive for surgery and MRI with a contrast agent. Exclusion criteria included diffuse or subependymal disease, pregnancy, tumors in the posterior fossa, enhancing tumor in both hemispheres, active infection, and radiation or chemotherapy within 4 weeks of enrollment. Surgical Procedure Enrolled patients underwent a clinically indicated

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Michael A. Vogelbaum, Cathy Brewer, Gene H. Barnett, Alireza M. Mohammadi, David M. Peereboom, Manmeet S. Ahluwalia, and Shenqiang Gao

also required to be at least 18 years of age and have a KPS of 70–100. The volume of the enhancing component of the recurrent tumor was required to be less than 40 cm 3 and patients were required to have laboratory values permissive for surgery and MRI with a contrast agent. Exclusion criteria included diffuse or subependymal disease, pregnancy, tumors in the posterior fossa, enhancing tumor in both hemispheres, active infection, and radiation or chemotherapy within 4 weeks of enrollment. Surgical Procedure Enrolled patients underwent a clinically indicated