Male, 63 years old, with lung cancer metastases to the brain status post radiation therapy. Multiple scattered small lesions are again seen in the brain and cerebellum compatible with treated metastases. Most of these lesions show minimal if any enhancement, and are primarily visualized by virtue of their susceptibility effect on T2 and SWI images. One lesion, at the junction of the right parietal and occipital lobes, does show heterogeneous enhancement, unchanged from prior. The size of this lesion, at 9 mm diameter, has also not significantly changed from the immediate prior examination and is smaller when compared to older studies. No new enhancing or susceptibility inducing lesions are seen.Patchy bilateral periventricular white matter T2 hyperintensity is seen. The extent of this finding has progressed when compared to prior examinations, though in the absence of mass effect or new enhancement, this is favored to represent posttreatment change. No new areas of parenchymal edema are detected. No acute intracranial hemorrhage is suspected. The ventricles are stable in size and morphology.Patchy opacification of the right mastoid air cells is unchanged. An area of thickening and enhancement involving the bony floor of the right middle cranial fossa is unchanged over multiple prior examinations, possibly representing an incidental benign fibro-osseous lesion or venous space.
Stable posttreatment appearance of numerous intracranial metastatic lesions. No new or growing lesions are seen.