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Purpose: To evaluate intra-patient and interobserver agreement in patients who underwent liver MRI with gadoxetic acid using two different multi-arterial phase (AP) techniques., Methods: A total of 154 prospectively enrolled patients underwent clinical gadoxetic acid-enhanced liver MRI twice within 12 months, using two different multi-arterial algorithms: CAIPIRINHA-VIBE and TWIST-VIBE. For every patient, breath-holding time, body mass index, sex, age were recorded. The phase without contrast media and the APs were independently evaluated by two radiologists who quantified Gibbs artefacts, noise, respiratory motion artefacts, and general image quality. Presence or absence of Gibbs artefacts and noise was compared by the McNemar's test. Respiratory motion artefacts and image quality scores were compared using Wilcoxon signed rank test. Interobserver agreement was assessed by Cohen kappa statistics., Results: Compared with TWIST-VIBE, CAIPIRINHA-VIBE images had better scores for every parameter except higher noise score. Triple APs were always acquired with TWIST-VIBE but failed in 37% using CAIPIRINHA-VIBE: 11% have only one AP, 26% have two. Breath-holding time was the only parameter that influenced the success of multi-arterial techniques. TWIST-VIBE images had worst score for Gibbs and respiratory motion artefacts but lower noise score., Conclusion: CAIPIRINHA-VIBE images were always diagnostic, but with a failure of triple-AP in 37%. TWIST-VIBE was successful in obtaining three APs in all patients. Breath-holding time is the only parameter which can influence the preliminary choice between CAIPIRINHA-VIBE and TWIST-VIBE algorithm., Advances in Knowledge: If the patient is expected to perform good breath-holds, TWIST-VIBE is preferable; otherwise, CAIPIRINHA-VIBE is more appropriate., (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Institute of Radiology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Objectives: To compare relative fat fraction (rFF) of active bone lesions from breast, prostate and myeloma malignancies and normal bone marrow; to assess its inter-reader agreement., Methods: Patients with breast ( n = 26), myeloma ( n = 32) and prostate cancer ( n = 52) were retrospectively evaluated. 110 baseline rFF maps from whole-body MRI were reviewed by two radiologists. Regions of interest for up to four focal active lesions in each patient were drawn on rFF maps, one each at the cervicothoracic spine, lumbosacral spine, pelvis and extremity. The mean and standard deviation of rFF were recorded. The rFF of normal marrow was measured in the pelvis for patients without diffuse bone disease ( n = 88). We compared the rFF of malignant bone lesions and normal marrow using Mann-Whitney test. Interobserver agreement was assessed by interclass correlation coefficient., Results: Malignant bone lesions showed significantly lower median rFF (13.87%) compared with normal marrow (89.76%) with little overlap ( p < 0.0001). There was no significant difference in the median rFF of malignant lesions from breast (14.46%), myeloma (13.12%) and prostate cancer (13.67%) ( p > 0.017, Bonferroni correction) and in the median rFF of bone disease according to their anatomical locations ( p > 0.008, Bonferroni correction). There was excellent interobserver agreement (0.95)., Conclusion: The low rFF of active bone lesions in breast, prostate and myeloma malignancies provides high image contrast relative to normal marrow that may be used to detect bone metastases., Advances in Knowledge: This study shows the importance of rFF towards detecting bone metastases.

Objectives: To investigate trends observed in a decade of published research on multimodality PET(/CT)+MR imaging in abdominal oncology, and to explore how these trends are reflected by the use of multimodality imaging performed at our institution., Methods: First, we performed a literature search (2009-2018) including all papers published on the multimodality combination of PET(/CT) and MRI in abdominal oncology. Retrieved papers were categorized according to a structured labelling system, including study design and outcome, cancer and lesion type under investigation and PET-tracer type. Results were analysed using descriptive statistics and evolutions over time were plotted graphically. Second, we performed a descriptive analysis of the numbers of MRI, PET/CT and multimodality PET/CT+MRI combinations (performed within a ≤14 days interval) performed during a similar time span at our institution., Results: Published research papers involving multimodality PET(/CT)+MRI combinations showed an impressive increase in numbers, both for retrospective combinations of PET/CT and MRI, as well as hybrid PET/MRI. Main areas of research included new PET-tracers, visual PET(/CT)+MRI assessment for staging, and (semi-)quantitative analysis of PET-parameters compared to or combined with MRI-parameters as predictive biomarkers. In line with literature, we also observed a vast increase in numbers of multimodality PET/CT+MRI imaging in our institutional data., Conclusions: The tremendous increase in published literature on multimodality imaging, reflected by our institutional data, shows the continuously growing interest in comprehensive multivariable imaging evaluations to guide oncological practice., Advances in Knowledge: The role of multimodality imaging in oncology is rapidly evolving. This paper summarizes the main applications and recent developments in multimodality imaging, with a specific focus on the combination of PET+MRI in abdominal oncology.