To the Editor: We thank Drs. Moss, Saran, and English for their comments. We agree that MRI remains the optimal method of imaging residual or recurrent desease in patients with choroid plexus carcinoma. The point of the case-description was to show that those tumors also take up Tc-99 m Sestamibi, and that this has the potential to be helpful in selected cases in addition to the MRIscan. We also thank the authors for reiterating the international agreement to repeat surgical approaches as often as possible to minimize tumor burden in this disease. It is not entirely clear to us, if the authors did or did not support our decision regarding a second resection of this patient's tumor. We would like to clarify that in this particular case, a second resection was likely to compromise the patient's functional status; there was a high risk of producing a significant visual cut. However, we do agree with the authors that in the absence of evidence-based clinical standards, a variety of treatment approaches could have been viewed as equaly valid. Since then, the international trial has been designed and we do support strongly the encouragement of Dres Moss, Saran, and English for clinicians to participate in the international trail. Lack of evidence should be corrected by creating the evidence.