The role of multiparametric magnetic resonance imaging (mpMRI) in assessing penile cancer is not well defined. However, this modality may be successfully applied for preoperative staging and patient selection; postoperative local and regional surveillance; and assessments of treatment response after oncological therapies. Previous studies have been mostly limited to a few small series evaluating the accuracy of MRI for the preoperative staging of penile cancer. This review discusses the principles of non-erectile mpMRI, including functional techniques and their applications in evaluating the male genital region, along with clinical protocols and technical considerations. The latest clinical classifications and guidelines are reviewed, focusing on imaging recommendations and discussing potential gaps and disadvantages. The development of functional MRI techniques and the extraction of quantitative parameters from these sequences enables the noninvasive assessment of phenotypic and genotypic tumor characteristics. The applications of advanced techniques in penile MRI are yet to be defined. There is a need for prospective trials and feasible multicenter trials due to the rarity of the disease, highlighting the importance of minimum technical requirements for MRI protocols, particularly image resolution, and finally determining the role of mpMRI in the assessment of penile cancer

Sarcoidosis is characterized by the presence of noncaseating granulomatous inflammation in the affected organs. Neurosarcoidosis denotes the involvement of the nervous system and can be either isolated or coexisting with extraneural systemic inflammation. The diagnosis of isolated neurosarcoidosis may be challenging due to unspecific symptoms and similar appearances with other disease processes. This report presents an uncommon case of intracranial sarcoidosis mimicking multiple meningiomas. Familiarity with the spectrum of magnetic resonance imaging findings in neurosarcoidosis is crucial to prevent interpretive errors which may in turn lead to an inappropriate diagnosis and treatment.

To evaluate metastatic lesions within the radiation field using repeated magnetic resonance imaging (MRI) and to compare the imaging findings with pain response following radiotherapy (RT) in patients with spinal metastases (SM) from breast cancer. 32 Patients with SM from breast cancer admitted for fractionated RT were included in this study. MRI examinations of the spine were scored for the extent of bone metastases, epidural disease and the presence and severity of vertebral fractures. Clinical response was defined according to the updated international consensus on palliative RT endpoints. At 2 and 6 months after RT, 38% and 44% of the patients were classified as responders. None of the patients developed motor deficits. Importantly, a decrease in the intraspinal tumor volume after RT was reported in all patients. Only 6% of the patients showed bone metastases progression within the RT field, whereas 60% of the patients showed disease progression outside the RT portals. 5 Patients developed new fractures after RT, and fracture progression was observed in 21 of the 38 lesions (55%). The pain response to RT did not correlate with the presence of vertebral body fracture before RT, fracture progression or other recorded MRI features of metastatic lesions. RT provided excellent local tumor control in patients with SM. Most patients benefit from RT even in cases of progressive vertebral fracture. Pain response was not associated with imaging findings and MRI cannot be used to select patients at risk of not responding to RT.

Cancer metastasis to bone is a frequent observation in malignancy that may result in complications such as pathological fractures and spinal cord compression. Monitoring treatment effects is the main concern in oncology; however, the evaluation of treatment response in bone is particularly challenging as it lacks well-established criteria. In addition, bone metastases have traditionally been considered non-measurable manifestations of cancer. Magnetic resonance imaging (MRI) is one of the most specific and sensitive methods for imaging skeletal metastases. The aim of this article is to highlight the diagnostic performance of MRI in the treatment monitoring of bone metastases, to review the current literature, and to provide an overview of recommendations for the evaluation of treatment response in bone.

Reduced field-of-view diffusion-weighted imaging (reduced-FOV DWI) is a promising technique for assessing tumor heterogeneity and microstructure. In this study, we evaluated the ability of reduced-FOV DWI to identify specific patterns associated with human papillomavirus (HPV) exposure in head and neck squamous cell carcinoma (HNSCC). Whole-lesion analysis of the tumor was performed on reduced-FOV and conventional DWI using a multi b value sequence. The extracted parameters included the 10th-90th percentile of the apparent diffusion coefficient (ADC) and fractional blood volume (fBV), skewness, and kurtosis. The differences between HPV-negative and HPV-positive tumors were greater for reduced-FOV DWI. ADC was significantly lower in HPV-positive tumors (reduced-FOV DWI: p < 0.001, r_90th = 0.50; conventional DWI: p < 0.001, r_10th = 0.49). The fBV was significantly lower in HPV-positive tumors on reduced-FOV DWI (reduced-FOV DWI: p_90th < 0.001, r_90th = 0.47; conventional DWI: not statistically significant). Moreover, there were significant differences between parameters derived from reduced-FOV and conventional DWI (ADC: p_10th−90th < 0.001, fBV: p_10th−50th < 0.001; skewness_{ADC, fBV}: p < 0.001, kurtosis_ADC: p = 0.008; kurtosis_fBV: p < 0.001). In conclusion, DWI parameters varied depending on HPV status and the differences between HPV-positive and HPV-negative tumors were greater for reduced-FOV DWI. The reduced-FOV DWI better reflected histopathology than did conventional DWI.