Clinical question: NSCLC restaging. Signs and symptoms: As above. Pre-and post-enhanced brain MRI:No diffusion weighted abnormalities.Examination demonstrates interval further decreased size of metastatic lesions since prior study. On the current exam there is only a single detectable metastatic lesion in the subcortical white matter of right frontal lobe measuring approximately 2.6 mm in size (axial post enhanced series 12 image 175) which previously measured at 4-mm. A 1 mm punctate focus of enhancement in the left cerebellum consistent with residual metastatic lesion which previously measured at 3.3-mm.there is no convincing evidence of any additional detectable metastatic lesions. Multiple small foci of flair hyperintensity in periventricular and subcortical white matter of bilateral cerebral hemispheres demonstrate no change. The findings could represent posttreatment/radiation changes.Unremarkable calvarium and orbits without evidence of abnormal enhancement.All paranasal sinuses demonstrate normal pneumatization signal pattern.
1.Negative diffusion weighted images.2.Further improvement of metastatic disease since prior exam as detailed. Some of the smaller lesions are no longer identified. Visualized remaining metastatic lesions are smaller than prior exam. Please see above comments as/measurements.3.Stable nonspecific periventricular and subcortical flair hyperintensity which could represent post treatment/radiation change.