To optimize surgical procedures of mediastinal masses, cardiac MRI with high temoral resolution has already proven its clinical value.
In this case of a 24-year-old male with suspicion of cardiac angiosarcoma Dr. Murray et al. (Mater Misericordiae University Hospital, Dublin, Ireland) present how cardiac MRI and syngo TWIST were able to characterize the tumor and its relationship to coronary vasculature in detail.
 
The evaluation of peritoneal metastatic spread is still a domain of computed tomography. But evolving MR techniques including continuous table move (syngo TimCT) allow the comprehensive evaluation of large parts of the body with MRI and can now be considered an alternative to CT in daily clinical practice. Henrik J. Michaely, M.D. from Mannheim University, Germany, demonstrates the clinical value of these refined MR techniques in a case of a rare metastatic hepatoid carcinoma of the prostate.
 
MR angiography plays an important role in the diagnostic work-up of peripheral vessel diseases. With recent concerns regarding the risk of NSF and also demands to reduce contrast media usage not only for renally impaired patients, the clinical need for non-contrast MR angiography has increased.
Holden et al. from the Centre for Advanced MRI, University of Auckland, New Zealand, compare in a case of right leg calf claudication the results of non-contrast MRA (syngo NATIVE) with conventional MR angiography and DSA.
 
Functional parameters and especially information on brain tissue perfusion is gaining importance in lesion characterisation. With the arterial spin labelling technique (syngo ASL), a non-contrast based method for the evaluation of brain perfusion is now clinically widely applicable and is potentially influencing imaging protocols. Oleaga et al. (case: Astrocytoma), Matsuda et al. (case: Alzheimer´s disease) and Rovira et al. (case: ITD) demonstrate in their case reports how syngo ASL is supporting the detection and characterisation of brain pathologies.
 
The early and correct estimation of metastatic spread is essential for an efficient therapy regime. Since cancer is often characterized by higher cellularity and therefore restriction of water diffusion, Diffusion-weighted imaging (DWI) with high b-values has been applied for imaging metastasis and therefore improve the diagnostic accuracy of MRI.
The working-group of Schlemmer et al. from the Department of Radiology, University of Tuebingen, Germany, show in a case of melanoma and non-Hodgkin lymphoma the potential of DWI to enhance staging and compared the findings with results of 18F-FDG PET/CT exams.
 
The differential diagnosis based upon conventional MR imaging would suggest a primary glial neoplasm. But displacement, rather than disruption of the fiber bundles at Diffusion Tensor Imaging (DTI) is suggestive of a lower grade neoplasm, confirmed at pathology to be a dysembryoplastic neuroepithelial tumor.
 
Diffusion Tensor Imaging (syngo DTI) adds clinical value to numerous indications for brain MRI within the daily clinical routine. In her talk at the 6th MAGNETOM World Summit in Munich, Dr. Tammie Benzinger shows how syngo DTI is integrated in the daily clinical routine at the Washington University School of Medicine (St. Louis, MO, USA).