Clinical question: History of metastatic NSCLC with a symptomatic brain metastases; please evaluate for disease progression. Findings and symptoms: Brain metastases. Pre- and post enhanced treatment planning MRI:Examination is performed utilizing treatment planning protocol and is not a true diagnostic study.Examination demonstrates interval increased size and surrounding vasogenic edema of a right parenchymal mildly hemorrhagic and enhancing metastatic lesion in the post central gyrus measuring 19 x 15 mm on current exam compared to prior study measurement of approximately 5 mm. Increased edema also results in mild regional mass effect.Multiple tiny additional metastatic lesions also demonstrate subtle interval increased size since prior study and the new mild surrounding vasogenic edema. For example a right inferior frontal metastatic lesion measures at 6 x 7 mm in transaxial dimensions compared to prior study measurement of approximately 3 mm in transaxial size. A punctate focus of metastatic enhancement in the vermis on prior exam has increased to approximately 4 mm in transaxial dimensions. A tiny left posterior cerebellar metastatic lesion demonstrate interval increased size and measuring approximately 5 mm in transaxial dimensions on current exam.
1.Interval increased edema and size of a right post central gyrus metastatic lesion to 19 x 15 mm in size compared to prior study measurement of 5 mm.2.Multiple smaller metastatic lesions both in supra and infratentorial parenchymal also demonstrate mild interval increased size since prior study as detailed/measured above.