43 years, Female, brain metastases. Treatment planning MRI for SRS.. Again seen are multiple enhancing lesions consistent with metastatic disease with evidence of progression since 4/16/2016. Note slight differences in imaging plane slightly limit comparison of measurements with 7/19/2016 study. Lesions with measurements on the post gadolinium axial 3-D T1 series 4 are as described below:Right frontal lobe lesion measures 6 x 5 mm, previously 6 x 4 mm. Image 85. There is small amount of hemorrhage associated with this lesion has before. There is mild interval increase in surrounding edema.Left cerebellar lesion measures 7 x 11 mm, previously 6 x 9 mm. Image 54. There is mild associated edema which appears slightly increased in the interval.Two adjacent right occipital lesions, one measuring 8 x 9 mm previously 7 x 7 mm, and the other measuring 8 x 5 mm, previously 6 x 5 mm. Images 85 through 94. Lesions appear to be along the cortical surface and possibly along the leptomeninges as noted before. There is susceptibility effect compatible with small amount of hemorrhage associated with these lesions, which is new versus subtly present previously and increased in the interval. There is also increase in edema associated with these lesions.Dural based enhancing lesion along the right frontal convexity appears slightly larger as well measuring approximately 12 mm in thickness, previously 9 mm. Image 23. No significant intracranial mass effect associated with the above-mentioned lesions. No midline shift or herniation.
1. Examination for treatment planning. There appears to be slight enlargement of multiple metastatic lesions compared to 7/19/2016 and more notable progression when compared to 4/12/2016.2. As noted before right occipital lesions are along the cortical surface and may involve the leptomeninges. There is also a right frontal dural based lesion.