Clinical question: History of metastatic lung cancer with brain metastases. Surveillance scan. Signs and symptoms: None. Pre and post enhanced brain MRI:No diffusion-weighted abnormalities.Compared to prior MRI exam from February 2015 there is near complete resolution of vasogenic edema surrounding a small right parietal metastatic lesion. Minute residual gliosis is identified. The enhancing metastatic focus however is again identified and measuring approximately at 5 x 6 mm in transaxial dimensions (axial post enhanced series 12 image 7). There is a slight interval decreased size of metastatic focus since prior MRI exam however when compared with postenhancement on the study from 3-10-15 lesion demonstrate interval increased size and intensity of enhancement since prior exam.A punctate focus of enhancement in the right frontal subcortical white matter consistent with metastatic lesion demonstrate interval significant decreased size since prior exam which measured approximately 5 mm in size. A small metastatic lesion noted in the right basal ganglia on prior exam cannot be identified on current study.Multiple small metastatic lesions in bilateral cerebellar hemispheres demonstrate decreased number since prior exam and remaining visualized metastatic foci are tiny and smaller than prior exam. Calvarium demonstrate no abnormal enhancement.Unremarkable images through the orbits including axial fat sat post enhanced series.
1.There is interval improvement of metastatic brain lesions since prior exam and with a few of the smaller previously seen metastatic lesions no longer identified on the current study.2.The largest remaining metastatic lesion in the right postcentral gyrus measures at 5 mm in transaxial dimensions. Compared to post enhanced only study from 3-10-15 there is subtle interval increased size of this lesion however when compared with earlier MRI exam from 2-13-15 there is interval decreased size of the lesion.