When contouring gliomas, how do you distinguish true tumor-related FLAIR from ischemic changes from prior strokes?

FLAIR alone often cannot reliably distinguish infiltrative tumor from chronic/subacute ischemic change. In a patient with a glioma and a previous stroke, the distinction should be made using the pattern of the FLAIR, temporal evolution, diffusion, perfusion, and sometimes metabolic imaging. The temp...

I rely on diagnostic radiologist discussions.