Six month MRI report says "central loss of enhancement" and my appointment is not for ten days. Is that good or bad?

Acoustic neuroma, right side, Gamma Knife in April with the frame. First follow-up MRI was last week and tonight the report appeared in the hospital app before anyone has spoken to me. I know, I know, I should not have opened it.

The bit about the tumour says "Interval central loss of enhancement within the right vestibular schwannoma. No significant change in overall dimensions." The rest is about my sinuses, which I am choosing to ignore.

I have now read the word LOSS about forty times. Loss of what? Is that the tumour dying or the treatment not taking? And "no significant change" sounds like a polite way of saying it did not work. My appointment is not until the 27th. Can anyone who has had this on their report tell me what it ended up meaning?

I had almost exactly that wording on my first scan. My consultant actually smiled when he read it out, which I was not expecting. I will let the mods explain it properly but you are not in bad news territory with that sentence.

No significant change is the result we all want and none of us believe when we first read it. Fifteen months of it here and counting.

Lorraine, I cannot read your scan from here and your team will interpret it with the images in front of them, but I can tell you what those two phrases usually mean, because they come up a lot.

Contrast dye lights up tissue with an active blood supply, and an acoustic neuroma usually enhances brightly before treatment. "Central loss of enhancement" means the middle of the tumour is taking up less dye than before, so it looks darker in the centre. It is commonly seen in the first year after radiosurgery and is generally read as a sign of the treatment acting on the tissue. It is not a size measurement, and "loss" here is describing the dye, not you losing anything.

"No significant change in overall dimensions" means it has not grown or shrunk beyond the millimetre or so that measurements vary by between scans. After radiosurgery for a benign tumour, the aim is control, so a stable size is usually exactly what the team hoped for. Many of these tumours stop growing but never get much smaller.

Worth knowing for next time: some acoustic neuromas swell temporarily in the first year or two before settling, so a later report saying "slightly increased" is not automatically bad news either. Ruth has put a plain glossary of the usual report phrases together in reading your MRI report after Gamma Knife, which may help you write your questions for the 27th. The two I would take are: is this the pattern you expected at six months, and when is the next scan.

Mr Edward Halloran said:

"loss" here is describing the dye, not you losing anything

I actually laughed at this, which is the first time this week. Thank you. Questions written on a post-it on the fridge.

They rang yesterday and moved the appointment forward because of a cancellation. Consultant said it is what he likes to see at this stage, stable with the centre changing, and next scan at twelve months. I have deleted the app from my phone until then.