Metastatic lung cancer. Status post 2 cycles of chemo. Evaluate for treatment response. There has been resolution or interval decrease in size of the intracranial metastases. For example a right parietal enhancing lesion previously measuring 6 x 5 mm is no longer enhancing. Previously seen mild associated T2/FLAIR hyperintensity has also decreased. A prior 7 x 6 mm anterior right frontal lobe lesion is no longer appreciated. There is a very faint enhancing right occipital lesion measuring 1 to 2 mm, previously 2 x 3 mm. Additional tiny focus of enhancement in the left cerebellum is no longer perceptible. Additional punctate foci of enhancement in the right occipital lobe and posterior right frontal deep white matter have also decreased in conspicuity. Susceptibility effect is present at the site of some of the prior lesions compatible with mineralization or punctate chronic blood products.No new lesions, edema, or mass effect is evident. No evidence of acute ischemia. Ventricles and sulci are within normal limits.There is mild mucosal thickening involving the bilateral maxillary sinuses and right anterior ethmoid air cells which is increased in the interval. Bone marrow signal and extracranial soft tissues are grossly unremarkable.
Previously seen multiple small intracranial metastases have decreased in size or no longer perceptible and consistent with treatment response.