Glioblastoma. On temozolomide. The study is mildly to moderately limited by patient motion.The ring-enhancing mass in the right temporal lobe has perhaps very minimally increased in size. Axially, the lesion measures 5.4 cm x 4.6 cm compared to 5.1 cm x 4.6 cm previously in December 30, 2015. Additionally, the intensity and thickness of the rim contrast enhancement are improved but this may relate to differences in technique (the current examination was obtained on 1.5 Tesla system while the previous examination was obtained on a 3.0 T system). Also, ependymal/subependymal contrast enhancement involving the atrium of the right lateral ventricle is less conspicuous.The similar though smaller lesion deeply seated in the anterior-inferior aspect of the right parietal lobe is not significantly changed in size but also shows less intense rim contrast enhancement. It measures axially 3.0 cm x 2.2 cm compared to 3.3 cm x 1.9 cm previously. Lateral to this, the T1-hyperintense hematoma has regressed in size measuring 1.8 cm compared to 2.7 cm previously. The T2 hyperintensity in the white-matter surrounding the ring-enhancing lesions is not significantly changed nor the associated mild mass-effect. Mild midline shift remains unchanged. Mild dilatation of the third and lateral ventricles is also unchanged. Periventricular and deep white-matter T2-hyperintensity in the left cerebral hemisphere, which is separate from the tumor, is unchanged. Also, cortical T2-hyperintensity in the left temporal lobe and subcortical abnormality in the left parietal lobe also remain unchanged and may represent foci of additional tumor.
1.Compared to previous examinations from December 30, 2015 and January 29, 2016, the two right temporal and parietal ring-enhancing lesions are not significantly changed nor the associated infiltrative edema and mass-effect. The dominant right temporal ring-enhancing lesion may be very minimally larger but the contrast enhancing rim is thinner and the associated subependymal enhancement is less conspicuous.2.Focal T2-hyperintensity in the left temporal and parietal lobes also remain unchanged and may reflect foci of gliomatosis.