Restaging lung cancer There is no definite evidence of intracranial metastatic disease. There is a 5 mm focus of enhancement in the left superior parietal lobule seen only on the sagittal post gadolinium series 1101, image 10, and favored to represent artifact. Unchanged punctate foci of susceptibility, likely representing chronic blood products or mineralization, are noted in supra- and infratentorial locations at sites of prior metastases. There is no mass effect or midline shift. There is mild cerebral volume loss with extensive white matter T2 hyperintensity, which appears more confluent in the parietal lobes compatible with chronic small vessel ischemic changes and probable superimposed post treatment changes. There is no restricted diffusion, evidence for acute intracranial hemorrhage or extra-axial collection. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear.
There is no definite evidence of intracranial metastatic disease. There is a 5 mm focus of enhancement in the left superior parietal lobule seen only on the sagittal post gadolinium sequence and is favored to represent artifact. Consider short-term follow-up for further evaluation as clinically indicated.