Eval GBM. Pt s/p RT/TMZ an 6 cycles of TMZ+TTF Perfusion images were not adequately obtained due to technical factors.Right frontal craniotomy related to resection of right frontal lobe mass is again demonstrated. Fluid within the surgical cavity along the medial right frontal lobe near the vertex is again demonstrated. Inferiorly, adjacent to the anterior horn of the right lateral ventricle is redemonstration of nodular enhancing soft tissue which appears more prominent when compared to prior examination (coronal postcontrast series1202, image 87). There is also increased enhancement extending inferiorly along the right lateral ventricle ependyma. A small amount of hemosiderin deposition in the surgical bed is again demonstrated. T2/FLAIR signal surrounding the surgical cavity appears similar to prior examination. There is no diffusion restriction to suggest acute ischemia. No significant midline shift is appreciated. No new intra-axial or extra-axial fluid collections are visualized.
Nodular enhancing soft tissue inferior to the surgical cavity and adjacent to the anterior horn of the right lateral ventricle appears more prominent with increased inferior extension along the right lateral ventricle ependymal margin when compared to prior examination concerning for tumor progression.