Malignant neoplasm of brain, unspecified [C71.9], Reason for Study: ^Reason: eval GBM on Avastin+CCNU. History: GBM. Brain MRIThere again is the right frontal intra axial mass which shows mixed signal intensity on T2 and minimal peripheral enhancement. Previously the size of the lesion on T2 coronal scan was 18.6mm x 34mm and on axial scan it was 25.8mm x 33.4mm. Today, the corresponding scan showed increased in size since prior scan, the measured size were 25.5mm x 38.9mm on T2 coronal scan and 28.7mm x 31.7mm. The pattern of enhancement of the lesion appears to be slightly lessen especially on the lateral aspect of the mass, but overall it does not show significant interval change since prior scan.The extent of surrounding edema also does not show any significant interval change.No evidence of acute ischemic or hemorrhagic lesion on this scan.The ventricles, sulci and cisterns are unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.MR perfusionThere is focal increased rCBV and rCBF on the anterior superior aspect of the intra axial mass indicating active tumor burden or increased angiogenectic activity. Corresponding brain MRI shows focal enhancement which again support the evidence of active tumor.
Interval increase size of the right frontal lesion with increased perfusion indicating interval progression of the tumor. There is no other lesion seen.No evidence of acute ischemic or hemorrhagic lesion.