Clinical question: Evaluate status of NSCLC brain metastases. Status post WBRT in 1-15. Signs and symptoms: Brain metastases. Pre and post enhanced brain MRI:Examination demonstrates noticeable interval improvement of parenchymal metastatic lesions since prior study. As for example a high convexity (median frontal metastatic lesion which measured approximately 13 mm in transverse axis has decreased to 8 mm on current exam and with minimal residual surrounding vasogenic edema.A large necrotic rim enhancing tumor in the right posterior temporal lobe which measured that 22 x 19 mm on prior exam has decreased to approximately 12 x 11.5 mm. Moderate surrounding vasogenic edema and regional mass effect with this lesion is present.A left posterior temporal enhancing metastatic lesion which measured at 11 mm on prior study has decreased to approximately 6.5 mm on current exam.Additional smaller metastatic lesions all demonstrate interval further decrease in size as well. Ventricular system remains within normal size and the maintained midline.Similar to prior exam there are patchy and confluent foci of FLAIR hyperintensity in the white matter of bilateral cerebral hemispheres (left greater than right) without change which could represent a combination of post treatment/radiation change and small vessel ischemic strokes.Calvarium is unremarkable.Unremarkable images through the orbits and including axial fat sat post enhanced series.All paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal patterns.
Interval decreased size and surrounding vasogenic edema of multiple intracranial metastatic lesions as detailed/measured above.