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This review article summarizes the clinical applications of established and emerging PET tracers in the evaluation of the 5 most common gynecologic malignancies: endometrial, ovarian, cervical, vaginal, and vulvar cancers. Emphasis is given to 2-deoxy-2-[ 18 F]fluoro-d-glucose as the most widely used and studied tracer, with additional clinical tracers also explored. The common imaging protocols are discussed, including standard dose ranges and uptake times, established roles, as well as the challenges and future directions of these imaging techniques. The key points are emphasized with images from selected cases., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2021 Elsevier Inc. All rights reserved.)

PET/MR imaging is in routine clinical use and is at least as effective as PET/CT for oncologic and neurologic studies with advantages with certain PET radiopharmaceuticals and applications. In addition, whole body PET/MR imaging substantially reduces radiation dosages compared with PET/CT which is particularly relevant to pediatric and young adult population. For cancer imaging, assessment of hepatic, pelvic, and soft-tissue malignancies may benefit from PET/MR imaging. For neurologic imaging, volumetric brain MR imaging can detect regional volume loss relevant to cognitive impairment and epilepsy. In addition, the single-bed position acquisition enables dynamic brain PET imaging without extending the total study length which has the potential to enhance the diagnostic information from PET., Competing Interests: Disclosure F. Moradi has nothing to disclose. A. Iagaru disclosed receiving consulting and research support from GE Healthcare, Progenics, and Novartis and consulting fee from ITM. J. McConathy disclosed receiving consulting and research support from GE Healthcare, Blue Earth Diagnostics, and Eli Lilly/Avid Radiopharmaceuticals., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Breast magnetic resonance (MR) imaging is the most sensitive imaging modality for breast cancer detection and guidelines recommend its use, in addition to screening mammography, for high-risk women. The most recent American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) manual coordinated cross-modality BI-RADS terminology and established an outcome monitoring section that helps guide a medical imaging outcomes audit. This article provides a framework for performing a breast MR imaging audit in clinical practice, incorporating ACR BI-RADS guidance and more recently published data, clarifies common pitfalls, and discusses audit challenges related to evolving clinical practice., Competing Interests: Disclosure Dr J.M. Lee has a research grant from GE Healthcare, United States., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Reporting MR imaging of pelvic floor dysfunction can be made easy if radiologists understand the aim of each MR sequence and what to report in each set of MR images. For an MR imaging report that is critical in decision making for patient management, it is of paramount importance to the radiologist to know what to look for and where to look for it. This article presents a new term, integrated MR analytical approach. A reporting template is included in which all MR findings are presented in a schematic form that can be easily interpreted by clinicians from different subspecialties., (Copyright © 2019 Elsevier Inc. All rights reserved.)

MRI is a commonly used diagnostic tool in neurology, and all neurologists should possess a working knowledge of imaging fundamentals. An overview of current and impending MRI techniques is presented to help the referring clinician communicate better with the imaging department, understand the utility and limitations of current and emerging technology, improve specificity and appropriateness when ordering MRI studies, and recognize key findings., (Copyright © 2019 Elsevier Inc. All rights reserved.)

The potential role of cardiac MR imaging in the diagnosis, risk-stratification, and treatment of patients with cardiac arrhythmias is rapidly evolving. Beyond substrate identification and characterization, it is now feasible to perform MR imaging-based noninvasive virtual programmed stimulation to identify potential ablation targets. The next phase of MR imaging-guided electrophysiology may involve intraprocedural guidance of electrophysiologic interventions using real-time MR imaging. This review discusses the spectrum of MR imaging applications in electrophysiology ranging from those that are established in clinical practice to those that are in the experimental phase of development., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Multiparametric MR imaging is being used for prostate cancer diagnosis. However, many cancers are missed and the performance needs to improve before it can be used for population-level screening. We can expect standardization of multiparametric MR imaging and increased use of quantitative multiparametric MR imaging, which will lead to more reproducible results and improved interpretation. The development and integration of new acquisition techniques and use of artificial intelligence for image interpretation can lead to implementation of new clinical MR methods. These will lead to increased adoption of multiparametric MR imaging for prostate cancer diagnosis and for guiding intervention and follow-up., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Clinical PET/MR imaging is being implemented at institutions worldwide as part of the standard-of-care imaging for select oncology patients. This article focuses on oncologic applications of PET/MR imaging in cancers of the head and neck. Although current published literature is relatively sparse, the potential benefits of a hybrid modality of PET/MR imaging are discussed along with several possible areas of research. With the increasing number of PET/MR imaging scanners in clinical use and ongoing research, the role of PET/MR imaging in the management of head and neck cancer is likely to become more evident in the near future., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Breast MR imaging is the most sensitive modality for breast cancer detection. This high sensitivity has led to widespread adoption of this technique, particularly in screening women at elevated risk for breast cancer. Despite its high sensitivity, standard breast MR imaging protocols are limited by moderate specificity and relative higher cost, longer examination time, longer interpretation time, and lower availability compared with mammography and ultrasound. As such, new techniques in MR imaging, including abbreviated breast MR imaging, pharmacokinetic modeling, and diffusion-weighted imaging, are active areas of research. This article discusses the rationale, current evidence, and limitations of these new MR imaging techniques., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Magnetic resonance spectroscopy (MRS) is a noninvasive functional technique to evaluate the biochemical behavior of human tissues. This property has been widely used in assessment and therapy monitoring of brain tumors. MRS studies can be implemented outside the brain, with successful and promising results in the evaluation of prostate and breast cancer, although still with limited reproducibility. As a result of technical improvements, malignancies of the musculoskeletal system and abdominopelvic organs can benefit from the molecular information that MRS provides. The technical challenges and main applications in oncology of (1)H MRS in a clinical setting are the focus of this review., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Cancer therapy is mainly based on different combinations of surgery, radiotherapy, and chemotherapy. Additionally, targeted therapies (designed to disrupt specific tumor hallmarks, such as angiogenesis, metabolism, proliferation, invasiveness, and immune evasion), hormonotherapy, immunotherapy, and interventional techniques have emerged as alternative oncologic treatments. Conventional imaging techniques and current response criteria do not always provide the necessary information regarding therapy success particularly to targeted therapies. In this setting, MR imaging offers an attractive combination of anatomic, physiologic, and molecular information, which may surpass these limitations, and is being increasingly used for therapy response assessment., (Copyright © 2016 Elsevier Inc. All rights reserved.)

The authors discuss eight areas of quantitative MR imaging that are currently used (RECIST, DCE-MR imaging, DSC-MR imaging, diffusion MR imaging) in clinical trials or emerging (CEST, elastography, hyperpolarized MR imaging, multiparameter MR imaging) as promising techniques in diagnosing cancer and assessing or predicting response of cancer to therapy. Illustrative applications of the techniques in the clinical setting are summarized before describing the current limitations of the methods., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Dynamic contrast-enhanced (DCE) MR imaging is used increasingly often to evaluate tumor angiogenesis and the efficacy of antiangiogenic drugs. In clinical practice DCE-MR imaging applications are largely centered on lesion detection, characterization, and localization. In research, DCE-MR imaging helps inform decision making in early-phase clinical trials by showing efficacy and by selecting dose and schedule. However, the role of these techniques in patient selection is uncertain. Future research is required to optimize existing DCE-MR imaging methods and to fully validate these biomarkers for wider use in patient care and in drug development., (Copyright © 2016 Elsevier Inc. All rights reserved.)

DW and DCE MR imaging contribute significantly to diagnosis, treatment planning, response assessment, and prognosis in personalized cancer medicine. Nevertheless, the need for further standardization of these techniques needs to be addressed. Whole-body DW MR imaging is an exciting field; however, future studies need to investigate in more depth the biologic significance of the findings depicted, their prognostic relevance, and cost-effectiveness in comparison with MDCT and PET/CT. New MR imaging probes, such as targeted or activatable contrast agents and dynamic nuclear hyperpolarization, show great promise to further improve the care of patients with cancer in the near future., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Tremendous advances have been made in abdominopelvic MR imaging, which continue to improve image quality, and make acquisitions faster and robust. We briefly discuss the role of non-Cartesian acquisition schemes as well as dual parallel radiofrequency (RF) transmit systems in the article to further improve image quality of the abdominal MR imaging. Furthermore, the use of hybrid PET/MR systems has the potential to synergistically combine MR imaging with PET acquisition, and the evolving role of hybrid PET/MR imaging is discussed., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Utilization of abdominopelvic MR imaging continues to increase in volume and gain widespread clinical acceptance. Many factors such as diaphragmatic respiratory motion, bulk patient motion, and the need for large volumetric coverage while maintaining clinically feasible scan times have proven challenging for body applications of MRI. However, many advances in MR acquisition, including non-Cartesian T1-weighted and T2-weighted acquisitions, advanced Dixon sequences, and 3-dimensional volumetric T2-weighted imaging have helped to mitigate some of the issues which have hampered abdominopelvic MR. This article will summarize these advances in T1-weighted and T2-weighted imaging, with an emphasis on clinical applications and implementation., (Copyright © 2015 Elsevier Inc. All rights reserved.)

PET and magnetic resonance (MR) imaging have each become essential tools in the workup and management of cardiac patients. Combined PET/MR systems have recently been developed, allowing for single-session imaging using both modalities. This new technology holds great promise for cardiac applications given the different, yet complementary, information each modality provides. Research in this area is still nascent, although early studies have been promising., (Copyright © 2015 Elsevier Inc. All rights reserved.)

A 12-core systematic biopsy that incorporates apical and far-lateral cores in the template distribution allows maximal cancer detection and avoidance of a repeat biopsy while minimizing the detection of insignificant prostate cancers. Magnetic resonance imaging-guided prostate biopsy has an evolving role in both initial and repeat prostate biopsy strategies, potentially improving sampling efficiency, increasing the detection of clinically significant cancers, and reducing the detection of insignificant cancers. Hematuria, hematospermia, and rectal bleeding are common complications of prostate needle biopsy, but are generally self-limiting and well tolerated. All men should receive antimicrobial prophylaxis before biopsy., (Copyright © 2014 Elsevier Inc. All rights reserved.)

The main imaging modality of the urinary tract in children is ultrasound. When further cross-sectional morphologic examination and/or functional evaluation is required, magnetic resonance (MR) imaging is the logical and optimal second step, particularly in pediatric patients. There are two main exceptions to this. The first one is when after an ultrasound, additional diagnostic imaging for urolithiasis is needed. The second one involves severe polytrauma, including blunt abdominal trauma. In this review, an overview of the MR imaging and computed tomography examinations important for current and future daily pediatric uroradiologic practice is presented., (Copyright © 2013 Elsevier Inc. All rights reserved.)

This article presents an overview of liver and biliary contrast agents including their mechanisms of action, dosage and elimination, current clinical indications, and potential future uses., (Copyright © 2012 Elsevier Inc. All rights reserved.)

The rotator cable is an extension of the coracohumeral ligament coursing along the undersurface of the supraspinatus and infraspinatus tendons. The rotator cable is thought to play a role in the biomechanical function of the intact and torn rotator cuff. It can be seen on all the imaging planes used for the conventional magnetic resonance imaging of the shoulder. Clinically, the integrity of the rotator cable can play a role in the treatment selection for patients with a rotator cuff tear., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Internal causes of impingement are secondary to rotator cuff and capsular dysfunction and are categorized by the location of the impingement and the underlying pathophysiological or mechanical cause of the impingement. These include posterosuperior impingement, anterosuperior impingement, anterior impingement, and entrapment of the long head of the biceps tendon. The objective of this article is to review magnetic resonance imaging findings of each of the 4 types of internal impingement syndromes and discuss the pathophysiology behind the impingement., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Magnetic resonance (MR) imaging is a modality widely used to assess shoulder abnormalities in children. A thorough understanding of the development of the shoulder and adequate MR techniques are crucial in the radiologic evaluation. The immature skeleton is particularly vulnerable to insults such as trauma, infection, and inflammation, and responds in unique ways. The pediatric shoulder can also be affected by complex congenital deformities such as brachial plexus injuries. In addition, certain neoplasms can be seen specifically in the young patient. MR imaging plays a critical role in the initial diagnostic evaluation and in assessing posttreatment responses., (Copyright © 2012 Elsevier Inc. All rights reserved.)

The rotator interval is an anatomically defined triangular area located between the coracoid process, the superior aspect of the subscapularis, and the anterior aspect of the supraspinatus. It is widely accepted that the rotator interval structures fulfill a role in biomechanics and pathology of the glenohumeral joint and long head biceps tendon. However, there is ongoing debate regarding the biomechanical details and the indications for treatment. A better understanding of rotator interval anatomy and function will lead to improved treatment of rotator interval abnormalities, and guide the indications for imaging and surgical intervention., (Copyright © 2012 Elsevier Inc. All rights reserved.)

The role of magnetic resonance imaging in evaluating shoulder arthropathies is evolving. This article reviews 4 of the major arthropathies: septic arthritis, rheumatoid arthritis, calcium pyrophosphate dihydrate (CPPD) deposition disease, and hydroxyapatite disease (HAD), with special attention to their magnetic resonance imaging features. Comfort with identifying these entities allows appropriate and prompt treatment, which is critical for joint preservation in the case of infection, for maximal therapeutic efficacy of disease-modifying drugs in the case of rheumatoid arthritis, and for expediting symptomatic relief in the cases of CPPD deposition disease and HAD., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Magnetic resonance (MR) imaging plays a major role in helping to identify rotator cuff disease and in demonstrating the pathology associated with external impingement. Many surgeons rely on MR imaging to assist in decision making and presurgical planning for patients with rotator cuff pain. This article reviews the etiology of external impingement and rotator cuff tears, and describes the MR imaging appearance of the normal and the pathologic rotator cuffs. It focuses on the supraspinatus tendon because this is the tendon involved in 95% of rotator cuff tears., (Copyright © 2012 Elsevier Inc. All rights reserved.)

The glenohumeral joint provides the greatest range of motion of any joint in the human body. Over the past several decades, histologic studies, biomechanical studies, and improved arthroscopic techniques have contributed to improved knowledge and treatment of glenohumeral joint abnormalities. Continuing advances in magnetic resonance technology have allowed for improved noninvasive visualization of the stabilizers of the shoulder. This article reviews the concept of glenohumeral joint microinstability and its relationship with superior labrum anterior and posterior (SLAP) lesions, reviews the role of the labrum as a stabilizer of the shoulder, and focuses on the diagnosis and classification of SLAP lesions., (Published by Elsevier Inc.)

The glenohumeral joint enables tremendous range of motion at the expense of stability. Functional stability is maintained by the synchronous coordination of complex static and dynamic structures. Symptomatic glenohumeral instability most often results from injury to the inferior labral-ligamentous complex, the primary passive stabilizer of the shoulder. This article reviews the structures important in glenohumeral stabilization and illustrates their normal appearances and the abnormalities associated with anterior, posterior, and multidirectional instability. These lesions are discussed in the context of therapeutic decision making., (Copyright © 2012 Elsevier Inc. All rights reserved.)

The anatomic and histologic descriptions of the rotator cuff tendons and footprints are continuously evolving, and new discoveries have led to novel concepts in our understanding of rotator cuff tendon pathology. These concepts may be translated into the analysis of these footprints with imaging methods, particularly magnetic resonance imaging., (Copyright © 2012 Elsevier Inc. All rights reserved.)

The extreme range of motion at the shoulder, high velocities and stresses, and repetitive nature of the throwing motion place the throwing athlete at risk for a wide range of pathologic entities. The treating orthopedist must fully understand the biomechanics of the throwing cycle and how it contributes to the potential injuries in the throwing shoulder during each phase of the throwing motion. The goal of orthopedic care and rehabilitation is to allow the throwing athlete to return symptom free to the preinjury level of competition., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Entrapment neuropathies are a rare but presumably underdiagnosed cause of shoulder pain and painful instability. Radiologists must be aware of the clinical presentations and imaging features of these neuropathies because they may be the first to suggest these diagnoses. In this article, instead of a classical nerve-by-nerve approach, entrapment neuropathies are deciphered according to the clinical situation: which anatomic structures may be involved, how to explore them, which imaging abnormalities can be expected, how to manage differential diagnoses, and which therapeutic options can be considered., (Copyright © 2012. Published by Elsevier Inc.)

Improvement in both hardware and software has opened up new opportunities in magnetic resonance (MR) imaging of the shoulder. MR imaging at 3-T has become a reality, with the prospect of 7-T imaging on the horizon. The art of MR arthrography continues to improve, aided by the use of novel imaging positions. New techniques for three-dimensional imaging, the reduction of metal artifact, and biochemical imaging of cartilage hold great promise., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Magnetic resonance (MR) imaging should be part of the routine workup in suspected inflicted brain injury. The inclusion of diffusion-weighted MR imaging is essential for assessment of acute hypoxic-ischemic brain injury because of its sensitivity to delineate the extent of the lesions and because of its prognostic significance. MR imaging may offer additional help in dating the intracranial hemorrhages, but a precise timing is often difficult if not impossible., (Copyright © 2012 Elsevier Inc. All rights reserved.)

The development of the spinal canal and its contents is highly complex and involves multiple programmed anatomic and functional developmental and maturational processes. Correct and detailed knowledge about spinal malformations is essential to understand and recognize these lesions early (preferably prenatally) to counsel parents during pregnancy, to plan possible intrauterine treatments, and to make decisions about the mode of delivery and the immediate postnatal treatment. This article discusses the imaging findings of the most frequently encountered neonatal spinal malformations and correlates these findings with the relevant embryologic processes. The presented classification is based on a correlation of clinical, neuroradiologic, and embryologic data., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Breast cancer is the most common solid tumor diagnosed in women. In the past decades, great strides have been made in breast cancer screening. While multiple screening trials have shown the benefits of screening mammography, there are limitations to x-ray mammography. Given these inherent limitations, efforts have been made to develop adjunctive imaging techniques, including screening ultrasonography, gamma-specific breast imaging, breast tomosynthesis, dedicated breast computed tomography, and breast magnetic resonance (MR) imaging. This article addresses the current indications and advanced imaging applications of breast MR imaging., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Whereas the strength of scoring systems in osteoarthritis (OA) lies in detecting local changes, involving small parts of the structures of interest (ie, cartilage lesions), quantitative measures are powerful where minute changes occur homogeneously throughout large structures. Cartilage measurements at 1.5 or 3 Tesla are technically accurate, reproducible, and sensitive to change. The rate of change in knee OA was found to be 1% to 2% annually. Risk factors of cartilage loss include a high BMI, meniscal pathology, malalignment, advanced radiographic OA, bone marrow alterations, and focal cartilage lesions. MRI of articular tissues represents a potent tool in experimental, epidemiological and pharmacological intervention studies; however, it is only with the availability of disease modifying drugs that it will play a relevant role in clinical practice.

Magnetic resonance arthrography is widely used throughout the world for joint imaging. It extends the capabilities of conventional MR imaging because contrast solution distends the joint capsule, outlines intraarticular structures, and extends into soft tissue tears and defects. MR arthrography exploits the natural advantages gained from a joint effusion and can be performed on any joint.

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MR imaging) is emerging as a tool that can quantify changes in liver perfusion that occur in both diffuse and focal liver diseases. Recent data show promise for DCE-MR imaging of the liver in diagnosing fibrosis and cirrhosis before morphologic changes can be detected. It may also be valuable in the assessment of hepatocellular carcinoma and liver metastases. Acquisition parameters, postprocessing methods, applications, and recent results of DCE-MR imaging of the liver are also described. Finally, it reviews the limitations and future directions of DCE-MR imaging for liver applications.

Interest in advanced neuroimaging is growing and is certain to continue; new and faster sequences, better image quality, higher magnetic fields, and improved models of diffusion, perfusion, and functional connectivity are in constant development. The purpose of this article is to highlight recent advances in neuroimaging from two aspects: (1) those advances directly benefited by increases in field strength (increased T1, signal-to-noise ratio, magnetic susceptibility-sensitivity, and chemical shift) and how the increased signal-to-noise ratio can be used to trade off for other advantages and (2) those advances made in response to attempts to try to reduce the inherent artifacts encountered at higher field strengths (eg, reducing specific radiofrequency absorption in tissue and magnetic susceptibility).

This article focuses on preclinical and early clinical applications of renal cell MR imaging, on new developments in MR control of intrarenal gene therapy, and on several potential applications of molecular imaging techniques, mainly targeting cell receptors and enzyme activity, which could find exciting applications within the genitourinary tract.