Examination of participant in clinical trial [V70.7], Reason for Study: ^Reason: mets lung cancer, ALK+, brain mets -- s/p resection, now with a new brain lesion, pls c/w previous outside MRI brain to evaluate dx status. Pls provide bi-dimensional measurement. There is outside MR scan available which was performed on Jul 29 2015. Please be reminded that the imaging technique especially spatial resolution (field of view, matrix size and slice thickness) is different, direct comparison of the lesion size cannot be interpreted with caution.There is multilobulated irregularly enhancing right middle frontal gyrus intra axial mass which was measured about 16.8mm x 10.5mm on axial scan, 18.1mm x 10.4mm on sagittal scan, and 19.9mm x 11.6mm on coronal scan. The lesion was 17.3mm x 10.2mm on axial, 18mm x 10.3mm on sagittal scan, and 18.5mm x 10.9mm on coronal scan. Considering the difference in imaging parameters, there is no significant interval change in terms of maximum diameter in each scan direction.However, it appears to be that the enhancing portion of inferolateral aspect of the lesion could be more prominent on today's scan. Again this finding could also be related to the time of Gadolinium infusion and scanning.There are, however, small nodular enhancing lesions on right posterior parietal lobe (series 11, image 11/33), left frontal deep white matter (series 11. Image 10/33) and left postcentral gyrus (series 11, image 7/33). These lesions were not seen on prior scan. The ventricles, sulci and cisterns are symmetric and unremarkable. There is no edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Right middle frontal gyrus multiloculated irregularly enhancing lesion, no significant interval change in maximum diameter compared to outside scan with possible larger portion of enhancement especially inferolateral aspect.2. Newly seen nodular enhancing lesions on the right parietal lobe, left frontal and left parietal lobe as described above.