What tests are to be taken to confirm a hypodense lesion of the brain revealed in CT?

Q. What are the follow-up studies for a brain lesion seen in CT?

Answered by
Dr. Hitesh Kumar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 29, 2022

Hi doctor,

Last month the patient's issue started. I need an opinion for a plain CT study of the brain that reveals a hypodense lesion in the right parietal region with perilesional edema and mass effect as per the report. Is it a neoplastic pathology or granulomatous lesion, or does it need a clinical correlation and further tests, including a contrast MRI brain with spectroscopy?



Welcome to icliniq.com.

In your query, you have not mentioned the symptoms of the patient.

1. As per the attached reports (the attachments are removed to proect the patient's identity) of CT (computed tomography) or MRI (magnetic resonance imaging) brain - there are multiple lesions on the right side of the brain, which seem to be metastasis (possibly some cancer spread in the brain).

2. One possibility may be primary brain cancer.

3. If there are no other organ symptoms, PET (positron emission tomography) scans of the whole body may be thought to look for the primary cancer site in the body.

4. If some other body parts suspected of tumor or cancer be there or some accessible lesion in another body part is found, you can take a biopsy from that body part.

5. If no lesion is found in another body part, you can consider taking a biopsy or excision from the brain in consultation with a neurosurgeon.

6. Once tumor or cancer typing is made the next treatment (chemotherapy and/or radiotherapy will be based on biopsy findings).

7. In this situation, it is not advisable to decide about medicines by just seeing the MRI or CT report on chat consultation.

I suggest you take a whole-body PET scan and plan a consultation with a neurosurgeon. A physical consultation would be good.

Chat or online consultation can only give a direct suggestion in this situation.

By attachments, it seems the patient is already under supportive medical treatment from a nearby doctor.

Kind regards.

Thank you.

The whole body PET scan is done.

I will attach the PET scan report (attachment removed to protect the patient's identity). It is a confirmed tumor in the brain, so please provide proper suggestions.



Welcome back to icliniq.com.

Is there a tumor or cancer found in any other body part also in PET scan?

If no tumor or cancer is found in any other body part - then the next plan can be to consult a neurosurgeon and discuss a biopsy or excision of the brain tumor for confirmation and typing of the brain tumor.

Kind regards.

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