Margaret's MRI scans

13 December 2000 (to see later scans, click here)

The radiologist's report concludes:

"There has been extensive debulking of the necrotic central cavity of the tumour which now shows CSF attenuation. A scalp collection of fluid is also present consistent with a localised CSF leak. Focal areas of nodular enhancement are seen around the cavity walls consistent with residual tumour."
Dennis comment (on 13 December): sentence 1 we know - the operation of 6 November. Sentence 2 - the surgeon said that the amount of disturbance by the operation would see this problem persist for some weeks. Whether we are still within the period he had in mind we shall see. Sentence 3: as this is the first scan since the operation, it may be difficult for Dr Wheeler to say whether there has been significant regrowth; the surgeon said after the operation that all visible tumour had been removed.

Dr Wheeler commented (14 December): "What a magnificent debulk. You can never get everything, but this is a wonderful job." As to whether there was any regrowth she was not concerned by the 'rind' so much but was suspicious of a little spot of tumour material in one corner of the excision site - see extra pics below (there is a contrast difference between the two sets of photos, from my handling of them in our scanner). As regards the CSF bulge, she said this was not oedema - "Look at how the midline is back towards normal" (compare with 26 October pictures, below). As to whether the persistent bulge was within the surgeon's parameters, she thought it had gone on a bit long, and noted that another of Dr Cook's patient's had had the same problem. It had been decided in that case to have a physiotherapist make a 'brace' to keep the bulged fluid in place while the wound inside repaired itself and closed off the leakage from the ventricles to the excision [see image SL10, immediately below]. Dr Cook had already asked Dr Wheeler for copies of Margaret's scans; we are booked to see him on 7 February. I will check with his office next week to see if he thinks any earlier action desirable.

F1 Coronal + Gadolinium 13 December 2000

F1 Coronal + Gadolinium 13 December 2000 - detail of spot

26 October 2000

Approximately two months after the visit to China, and commencement of stronger herbal remedies and Gamma Knife radiotherapy (see the China report), Margaret had MRI scans in Canberra on 26 October, before medical appointments in Sydney on 31 October.

The radiologist's report read

"HISTORY: GBM

REPORT: An approximately 5cm diameter irregular mass with central cavitation and some focal haemorrhage confirmed in the left frontal lobe consistent with diagnosis of GBM. There is marked associated oedema and mass effect with subfalcial herniation of the mid line structure. High signal on the FLAIR images spreads down into the corpus callosum and left basal ganglia. However, compared with the previous scans of 2/9/2000 [2nd September] there does not appear to be any significant change.

CONCLUSION: No significant change since 2/9/2000."

Here are images from:

[1] the CORONAL FLAIR scan, which I understand subtracts the cerbrospinal fluid from the image, to show extent of oedema.

[2] The T1/TRAN+GAD, after intravenous injection of gadolinium to enhance the image.

The images of 2 September, referred to above, can be seen here, with earlier history.
To see later scans, after December 2000, click here