Surveillance. History of brain metastases, NSCLC, status post resection and SRS. Again seen are postsurgical changes of left temporal craniotomy for resection of left temporal lobe metastatic lesion. There is unchanged T2/FLAIR hyperintensity along the left temporal resection cavity consistent with gliosis. There is also no significant change in mild, slightly nodular enhancement around the resection cavity which is favored to represent posttreatment change. No new or enlarging lesions involving the resection cavity or within the remainder of the brain to suggest progression. There are no masses, mass effect or hydrocephalus. There is no evidence for intracranial hemorrhage or diffusion-weighted abnormalities. Scattered foci of T2/FLAIR hyperintensity in the white matter are nonspecific but compatible with mild chronic small vessel ischemic disease. Flow voids are present within the major vessels indicating patency. There is minimal scattered paranasal sinus mucosal thickening. Orbits, calvarium, and remainder of the extracranial soft tissues are grossly unremarkable.
Unchanged mild, slightly nodular enhancement surrounding the left temporal resection cavity favored to represent posttreatment change. No new or enlarging lesion to suggest progression of metastatic disease.