Hepatobiliary-specific Gd-based contrast agents (Gadobenate dimeglumine : Gd-BOPTA and Gadoxetic acid: Gd-EOB-DTPA) are one of several classes of contrast agents presently available for MRI of the liver. These agents are taken up by functioning hepatocytes and excreted in the bile, and their paramagnetic properties cause a selected enhancement of the liver and biliary tree. This results in an increased contrast-to-noise ratio for nonhepatocellular lesions compared with that of the background liver, thereby increasing lesion conspicuity on delayed T1weighted images. However, due to their pharmaco-dynamic properties, Gd-BOPTA and Gd-EOB-DTPA are sometimes described as "combination agents" because of their dual capability for imaging in the dynamic and delayed hepatocyte-specific phases of enhancement. These two agents potentially allow comprehensive noninvasive imaging assessment of the liver parenchyma, intrahepatic lesions, hepatic vessels, and the biliary tree in one examination. These MR contrast agents vary as Italian Association of Neuroradiology (AINR), Italian Association of Oncologic Radiotherapy (AIRO) and National Radiological Union (SNR). The great scientific activity of SIRM is proved by the Official Scientific Journal, "La Radiologia Medica", with an impact factor of 1.698. In the past decade Multislice CT Coronary Angiography (MSCT-CA) achieved excellent results in the diagnosis of coronary artery disease (CAD) with improving spatial and temporal resolution. High sensitivity and negative predictive value were elicited for the detection/exclusion of coronary artery stenoses in patients with suspected CAD. MSCT-CA may be employed in the emergency setting to perform the work-up of acute chest pain, including a one-stop-shop imaging of main thoracic killers: coronary syndrome without ST elevation at the ECG, pulmonary embolism and aorta dissection. Another relevant application is coronary plaque imaging which provides findings and clues of plaque vulnerability (i.e. composition and wall remodeling). MSCT-CA may address a paradigm shift from demonstration of ischaemia to the assessment of pure atherosclerosis. Recent studies pointed out the excellent prognostic value of the technique. Other potential applications of MSCT-CA are the assessment of revascularised patients (with stenting or coronary artery by-pass grafts), and the depiction of coronary anomalies. Radiation dose concerns triggered technical innovations such as higher spatial resolution with larger and novel detectors, faster data acquisition, modulation dose systems, and prospectively ECG-triggered high-pitch acquisition. New scanners may provide excellent image quality at a dose below 1 mSv, to levels lower than conventional angiography. MSCT-CA may also provide useful information of cardiac functional assessment (left and right ventricular function, evaluation of valves). In this context, the fusion imaging of hybrid scanners (CT and SPECT/PET) could represent a promising technological solution able to assess morphology and function at the same time. The winter Olympic Games held in Torino in 2006 were testimonial a very hard challenge which took on the form of the following motto: Passion Lives Here. This was also held dear in the organisation and set up of the diagnostic imaging, which was developed in three separate sites, at varying altitudes, reaching 2,000 metres high up in the Alps, in Sestriere. The most complete of diagnostic equipment was to be found there, including Ultrasound Diagnostic Equipment, C.T. Scans and Magnetic Resonance. Moreover, for the first time, all of these diagnostic techniques were pooled into a network that allowed for real-time visualisation/consultation between one site and another. The results gave credit to the organisational efforts, allowing for examinations and diagnosis to be made in the shortest possible time lapses. The pathologies diagnosed in the field of musculoskeletal imaging enabled the most suitable of surgical and/or therapeutic solutions to be chosen, as well as the possibility to programme the athletes' participation in the forthcoming competitions. Ultrasound examinations were carried out "on the field" for real-time interventions and the CT scans were done in dedicated containers at an altitude of 2,000 metres. It was for the first time that high field resolution Magnetic Resonance, both total body and those dedicated to new concepts, were executed at such an altitude, but, above all, the technology available was applied to this specific sports sector. Thanks to the excellent results obtained, satisfaction rates ran high for the athlete and medical teams alike. The evolution of ultrasound technology has allowed the wide application of colourflow duplex scanning (CFDS) in the imaging of abdominal arteries. Duplex criteria have been set to identify renal artery stenoses (RAS) that are haemodynamically significant. Threshold values for PSV consistent with a 60% or greater diameter reduction of the renal artery obtained in most studies are 180 to 190 cm/sec. In some cases it is useful to use the ratio between the velocity of the renal artery and the aorta. Threshold values of this ratio diagnostic of a 60% or greater RAS vary in different studies from 3 to 3.5. Renal hilar duplex scanning from a flank or translumbar approach has been suggested as a simplified alternative for screening, especially in those patients in whom conventional renal duplex examination is difficult to perform. Contrast-enhanced US (CEUS) seems promising in diminishing the rate of technically inadequate renal artery examinations. Regarding the mesenteric arteries, with adequate patient preparation, the CA and SMA can be identified and in mode of administration and dose, mechanism of cellular up-take, degree of excretion through the biliary pathway, and imaging characteristics. In the liver, hepatobiliary-specific agents can be used to improve lesion detection, to characterise lesions as hepatocellular or nonhepatocellular, and to specifically characterise some hepatocellular lesions, notably focal nodular hyperplasia. Biliary excretion of these agents can be used to evaluate the anatomic structure and function of the biliary tree. Hepatobiliary-specific contrast agents may have wider applications, such as grading of cirrhosis and quantification of liver function in patients with liver trasplantation. Clinical applications, advantages, pitfalls, and problems with different contrast agents will be described and discussed. Acute abdomen refers to any clinical condition characterised by severe abdominal pain that develops over a period of hours. This is a great challenge to the radiologist because differential diagnoses of acute abdomen include a wide spectrum of disorders, ranging from life-threatening diseases to benign self-limiting conditions. Rapid, accurate diagnosis is essential if morbidity and mortality have to be significantly decreased. The diagnostic work-up of patients admitted with acute abdomen is based on various imaging modalities such as abdominal plain film, ultrasound, CT and MRI: the topographic classification of acute abdominal pain (pain in one of the four abdominal quadrants, diffuse abdominal pain, flank or epigastric pain) facilitates the choice of the imaging technique and allows to narrow the range of possible diagnoses. A practical approach to acute abdomen is to confirm or to exclude the most common disease and to look for general signs of pathology such as inflamed fat, bowel wall thickening, ileus, free fluid, free air, etc: the role of US, CT and MRI in achieving these goals will be discussed. The common and more unusual causes of acute abdomen, with reference to the site of pain, will be also discussed in an interactive fashion. Findings useful for differential diagnoses will be presented in order to obtain the correct diagnosis beginning from the imaging sign. 58,240 Americans were diagnosed with renal cancer in 2010 and an estimated 13,040 will die from renal carcinoma in 2010. Deaths worldwide are over 100,000 annually making renal cancer one of the leading causes of cancer death. With the advent of cross sectional imaging modalities like CT and ultrasound over two thirds of cases of renal cell carcinoma are detected as incidental findings. Classic presentations like hematuria only occur in up to 40% of cases and so many of these patients are diagnosed with larger tumors. In this presentation we will focus on the role of state of the art CT for the detection, staging and management of the patient with known or suspected renal carcinoma. We will look at some of the challenges in diagnosis focusing on optimising scan protocols as well as the role of 3D mapping in staging and pre-operative planning. The role of imaging in patient management be it partial nephrectomy, ablation therapy or nephrectomy will be discussed. Potential pitfalls and limitations of study technique will be addressed. Finally we will also focus on some of the newer discoveries showing that enhancement patterns on CT can not only differentiate in most cases between papillary and clear cell RCC but enhancement patterns can also predict genetic errors which may impact on therapy for drug selection. Trends for future innovation will also be discussed. Global epidemiological statistics demonstrate that mortality from ovarian cancer has not changed in half a century. Advances in molecular medicine and biomedical imaging are poised to make a difference. Early ovarian cancer is treated with comprehensive staging laparotomy. For advanced disease deemed nonresectable, neoadjuvant chemotherapy followed by surgical debulking is recommended. In the management of ovarian cancer, cross-sectional imaging is now essential in (1) tumour detection and characterisation; (2) treatment selection and planning (identifying difficult-to-reach tumour deposits or inoperable disease for which neoadjuvant chemotherapy is indicated); (3) monitoring treatment response; (4) detecting recurrent disease, and, depending on tumour size and location, choosing between secondary cytoreduction and chemotherapy. Ultrasound is the primary modality for detecting and characterising adnexal masses. MRI is useful for characterising sonographically indeterminate adnexal masses, and contrast-enhanced CT is the modality of choice for preoperative staging. FDG PET-CT is valuable for detecting recurrent disease, particularly in the mesentery, bowel serosa and normal-sized lymph nodes. We are witnessing a paradigm shift in cancer care, as imaging permeates all facets of cancer diagnosis, treatment and follow-up. The opportunities for biomedical imaging have never been greater. Our role is to understand the key clinical questions and, using imaging, serve as essential physician consultants. Abnormalities of the abdominal aorta and the visceral vessels may represent a diagnostic challenge in patients with acute or chronic clinical symptoms. In addition to the primary diagnosis in b-scan, colour-coded duplex ultrasound, contrast-enhanced ultrasound (CEUS) with low mechanical index (low MI) is a new promising method in the diagnosis and follow-up of pathological aortic lesions. These pathology findings were compared with b-scan, colour-coded duplex ultrasound, CEUS and multislice computed tomography angiography (MS-CTA). Pathologies of the abdominal aorta will be often treated with an endovascular aneurysm repair (EVAR). Endoleaks following endovascular aneurysm repair (EVAR) are common and present a diagnostic challenge in the follow-up after EVAR. CEUS with SonoVue® allows a more rapid and noninvasive diagnosis in the follow-up after EVAR. This course will describe the aetiology, classification and importance of pathologies of the abdominal aorta and the different types of endoleaks allowing the participants to appreciate the usefulness of CEUS in this clinical situation. Despite advances in cross-sectional techniques imaging still has difficulties on assessing pancreatic tumours and in particular adenocarcinoma. The main problems remain the early detection of small tumours and the clearcut definition of patients that are amenable to curative surgery. After reviewing current concepts in the classification of pancreatic tumours including the role of molecular biomarkers, the lecture will address the strategies that may be used to maximise tumour conspicuity in a multi modality perspective that also encompasses uprising techniques such as dual energy CT, perfusion CT/MR and diffusion-weighted MRI. The concept of borderline resectable pancreatic cancer will be explained as well the key points for image interpretation in the setting of clinical decisions for patient management. Also, the current role of adjuvant or neoadjuvant therapy will be shortly addressed especially concerning its imaging implications, as well as the new concepts on pancreatic adenocarcinoma oncogenesis and possible imaging strategies that may be used for earlier detection. Optical imaging is unequivocally the most versatile and widespread visualisation modality in the life sciences. Yet it is significantly limited by photon scattering, which complicates imaging beyond a few hundred microns. Recently, however, there has been an emergence of powerful new optical imaging methods that offer high-resolution imaging beyond the penetration limits of microscopic procedures. Of particular importance is the development of multi-spectral opto-acoustic tomography (MSOT) methods that bring unprecedented imaging performance in visualising anatomical, physiological and molecular imaging biomarkers through several millimetres to centimetres of tissue. Its attractive features include the ability to offer 10-100 micron resolution and real-time imaging. In parallel, we have achieved the first in-human clinical translation of targeted fluorescent probes which opens the way for advanced surgical and endoscopy procedures and personalised theranostics and screening. MSOT can enable exceptional insights to cellular and sub-cellular processes through entire small animals, embryos, fish and insects. This talk describes current progress with instruments, methods and applications for in-vivo optical-and opto-acoustic tomography of whole intact animals and model biological organisms. We show how new opto-acoustic and fluorescence imaging concepts are necessary for accurate and quantitative molecular investigations in tissues and why it could be a valuable tool for accelerated research of therapeutic efficacy and outcome. We further demonstrate that cellular functions and bio-chemical changes can be detected in-vivo, through intact tissues at high sensitivity and molecular specificity. Pre-clinical and clinical results are presented and advantages and limitations of these methods along with future directions are discussed. Pulmonary nodules are one of the classic challenges in radiology: detection and lesion characterisation are constant sources of trouble, be it in the form of unnecessary workup or missed lesions and ensuing lawsuits. This presentation will review the progress that has been made on these issues and also discuss current limitations of radiological techniques. Human observers are notoriously inaccurate when it comes to detection and characterisation of nodules. Like the development in chess computers, computer programs (computer-aided diagnosis, CAD) now start to outperform humans. Rib suppression or temporal subtraction techniques on chest radiographs aid in lesion detection. New CAD techniques combine algorithms and can detect, quantify and characterise pulmonary lesions. However, while radiologists are still able to detect lesions missed by CAD, they also dismiss true-positive and accept false-positive CAD markers. CAD development has been stimulated by the large image databases from lung cancer screening trials. These trials provide new information about prevalence and prognosis of various nodule phenotypes: small solid nodules are extremely common but have a low cancer risk, persistent part solid and ground glass nodules (GGN) have a high malignancy rate and GNN grow slowly. Volume and mass doubling times are more accurate measures than nodule diameter. Form and location allow for identifying benign perifissural nodules. Dynamic-contrast-enhanced imaging with CT or MR as well as PET so far only plays a role in larger lesions. Still, however, the role of CT screening is not fully defined: false positives and radiation dose remain important issues. The possibility of carrying out Molecular Imaging protocols by means of MRI is very attractive for the superb anatomical resolution that is attainable by this technique. However, MRI suffers from an intrinsic insensitivity with respect to the competing imaging modalities that has to be overcome by designing suitable amplification procedures based on the development of reporting units endowed with an enhanced sensitivity and on the identification of efficient routes of accumulation of the imaging probes at the sites of interest. Now, the need of targeting molecules that are present at very low concentrations requires the development of novel classes of contrast agents characterised by enhanced contrasting ability and improved targeting capabilities. The possibility of delivering a high number of imaging agents at the target of interest appears the solution of choice to overcome the drawback associated with the low sensitivity of the MRI approach. Currently much attention is devoted to the design and use of self-assembled systems based on lipophilic molecules, where the imaging reporters are represented by highly stable paramagnetic Gd (III) complexes. Moreover, nano-sized carriers for Gd-complexes based on naturally occurring systems (e.g. lipoproteins) have also been considered for targeting specific epitopes on diseased cells. Besides paramagnetic agents much attention is currently devoted to the new class of frequency-encoding probes, the CEST agents (CEST= Chemical Exchange Saturation Transfer). The use of frequency-encoding agents opens the interesting perspective of detecting more than one agent in the same anatomical region. Ultrasound is one of the workhorses in clinical diagnosis. In this context, the diagnostic power of ultrasound can be increased when using microbubbles as contrast agents providing information about tissue vascularisation and perfusion. By conjugating biomolecules to the microbubble surface even intravascular molecular ultrasound imaging becomes feasible. In this context, for the discrimination of low-and high-aggressive breast cancers it has been shown that the assessment of the VEGFR2-expression by molecular ultrasound is superior to the functional information about tumour vascularisation. First targeted ultrasound contrast agents are currently evaluated in clinical trials. Potential clinical indications are characterisation of tumours, improvement of ultrasound guided biopsy, personalised tumour therapy, the characterisation of atherosclerotic plaques and the diagnosis of other diseases that go along with vascular remodelling and inflammation. Unfortunately, microbubble-based imaging is restricted to the endovascular compartment. Here, photoacoustic imaging may be helpful, which bases on the ultrasound acquisition of the thermoelastic expansion of nanoparticles after laser excitation. Haemoglobin, gold nanoparticles, dyes, fluorescent proteins and other light-absorbing materials can sensitively be imaged by this technique. In this talk, the composition of molecular ultrasound contrast agents and their measurement techniques will be explained and illustrated. In addition, the mechanistic principle of photoacoustic imaging will be explained intending to exemplify both emerging diagnostic technologies to the clinical radiologists. Friday and long-term assessment of therapeutic result is usually achieved by contrastenhanced CT (CECT) or MRI (CEMRI) which can be performed only at the end of the treatment session. In addition, the possibility of achieving local tumour control with percutaneous ablation is largely related to tumour size. Consequently, there is an increased need to detect and treat small tumours that are often clearly visualised on CT or MRI, but not on US. Contrast-enhanced sonography (CEUS) is helpful for guiding electrode insertions into targets hardly visible with US. However, the most important role of CEUS is the immediate post-ablation control. The sensitivity of CEUS for the detection of residual tumour is almost equivalent to that of CECT and CEMRI. Cost-effectiveness and reduction of patients' discomfort related to the need of re-treatment are the two main advantages of CEUS in RFA of liver malignancies. The use of CEUS during liver surgical resections is gaining more and more importance since it can allow to detect small additional neoplastic lesions not visualised in the pre-surgical staging with imaging modalities and to depict with great accuracy liver vascularity, thus allowing to perform precise liver-sparing anatomical resections. The routine practice of oncologic imaging requires standardisation, which means that we need to harmonise technical protocols and agree on the meaning of selected words for the radiological report. The words "Response, "Progression" and "Stable disease" are precisely defined according to internationally accepted thresholds and criteria. Although the rules are quite simple and rather easy to apply, they are very efficient in the classification of the response to treatment, and therefore for the medical decisions. However, the role of the radiologist is not limited to measurements and calculation. The detection of new lesions may be challenging and requires experience. The differential between cancer progression and complications of the treatment might be very difficult and requires an adequate communication with the referring clinician. Overall, most of the decisions taken by the clinician will be related to imaging results, stressing the importance of adequate protocols and reports. In the past decade, contrast-enhanced ultrasound (CEUS) of the liver has been firmly established as an excellent imaging modality for focal lesions. Its strong points include high spatial and contrast resolution as well as its unparalleled temporal resolution, enabling dynamic imaging after contrast injection in real time.