case_images: PMC9532156_01
case_images: Neck ultrasound for carotid artery study. The data showed mild atherosclerosis (< 15%) of bilateral carotid bifurcations and bilateral small-diameter vertebral arteries, with reduced flow volume (34 ml/min). (a) Right carotid bifurcation. (b) Left carotid bifurcation. (c) Right vertebral artery. (d) Left vertebral artery.
case_images: CRIOT2022-5877106.001.jpg
case_images: PMC9532156_01_CRIOT2022-5877106.001.jpg
case_images: fig1
case_images: Neck sonography showed mild atherosclerosis (<15%) of bilateral carotid bifurcations and bilateral small-diameter vertebral arteries, with reduced flow volume (Figures 1(a)-1(d)).
case_images: Magnetic resonance imaging (MRI) showed (a) a small enhancing focal lesion in the right temporal pole with a size of 9 mm x 7 mm, and brain radiation necrosis was suspected (arrow indicates the lesion with rim enhancement). (b) Superimposition of cumulative radiation dose distribution on transverse postcontrast MRI showing the relation between the radiation dose and lesion with rim enhancement (indicated with aqua).
case_images: CRIOT2022-5877106.002.jpg
case_images: PMC9532156_01_CRIOT2022-5877106.002.jpg
case_images: fig2
case_images: Five months later, a neck MRI showed a small enhancing focal lesion in the right temporal pole with a size of 9 mm x 7 mm, and brain metastasis was suspected (Figure 2(a)). D1 c.c. (dose to 1 ml of the temporal lobe volume), D0.5 c.c. and Dmax of the right and left temporal lobes were 11.1 Gy and 11.4 Gy, 8.5 c.c. and 6.7 c.c., 70.1 Gy and 67.1 Gy, 72.0 Gy and 68.8 Gy, and 74.2 Gy and 72.1 Gy, respectively (Figure 2(b)). Data were collected retrospectively with approval from the Institutional Review Board of the Far Eastern Memorial Hospital (FEMH-IRB-111147-C), and the requirement for informed consent was waived.