Figure 1

A patient known to have melanoma presents with a first seizure and (A) unenhanced CT brain (32-slice scanner, 10 mm slices) taken in the emergency department shows an abnormality in the left frontal lobe with surrounding oedema – they were referred for possible neurosurgical intervention. (B) T1 weighted MRI at 1.5 T with single dose (0.1 mmol/kg) gadolinium contrast detects this lesion but also delineates it further, allowing volume to be assessed accurately and in addition highlights two further areas of abnormality. After staging of the systemic disease and discussion with oncologists and surgeons, the patient was therefore treated with stereotactic radiosurgery to all three areas.