Kubik-Huch RA, Weston M, Nougaret S, Leonhardt H, Thomassin-Naggara I, Horta M, Cunha TM, Maciel C, Rockall A, Forstner R. European Society of Urogenital Radiology (ESUR) Guidelines: MR Imaging of Leiomyomas. Eur Radiol. 2018 Aug;28(8):3125-3137. doi: 10.1007/s00330-017-5157-5. Epub 2018 Feb 28. PMID: 29492599; PMCID: PMC6028852. Abdel Wahab C, Jannot AS, Bonaffini PA, Bourillon C, Cornou C, Lefrère-Belda MA, Bats AS, Thomassin-Naggara I, Bellucci A, Reinhold C, Fournier LS. Diagnostic Algorithm to Differentiate Benign Atypical Leiomyomas from Malignant Uterine Sarcomas with Diffusion-weighted MRI. Radiology. 2020 Nov;297(2):361-371. doi: 10.1148/radiol.2020191658. Epub 2020 Sep 15. Erratum in: Radiology. 2020 Dec;297(3):E347. PMID: 32930650. Smith J, Zawaideh JP, Sahin H, Freeman S, Bolton H, Addley HC. Differentiating uterine sarcoma from leiomyoma: BET1T2ER Check!. Br J Radiol 2021; 94: 20201332.

There are three distinct presentations of prostatic lymphomas (PL), with their own patterns of spread and imaging characteristics. MRI is useful for the positive diagnosis, extension and follow-up, but also for differential diagnosis. Symptoms of urinary obstruction, low PSA level, and/or history of preexisting systemic lymphoma or immunosuppression are other relevant indicators to evoke PL instead of classic prostate adenocarcinoma.

Prostate cancer encompasses a wide range of biological behavior. Patients with low/intermediate grade, localized disease would be considered for a more personalized treatment strategy targeting the dominant/largest tumor (index lesion) in order to obtain oncological control minimizing side effects seen on radical treatments that highly impact the patient’s quality of life, such as urinary incontinence and erectile dysfunction. The MR guidance of focal therapies is a rapidly emerging technique which allows optimal visualization of the target lesion and monitoring of the delivered energy. Initial studies have demonstrated low complication rates without compromising oncological control. However, to our knowledge, this is only applicable in the setting of prospective clinical trials and the evidence of long-term outcomes is under construction.

Teaching objectives Abdominal and pelvic pain are common symptoms in pregnant woman that may subtend an emergency condition leading to life-threating for the fetus and the woman, for which a prompt surgical intervention is required. The causes of abdominal pain in pregnancy can be obstetric and non-obstetric, including gynecological, gastrointestinal, hepatobiliary, and genitourinary pathologies. However, an early diagnosis can be challenging due to the several changes occurring in pregnancy, such as a displacement of abdominal and pelvic structures from their normal locations by the enlarged gravid uterus. Ultrasound (US) is the first-line imaging modality, but Magnetic Resonance Imaging (MRI) is gaining favor due to its accuracy, fast protocols and safety. Rewiew of the topic and conclusion MRI is an important diagnostic tool in pregnancy because of its safety profile due to absence of ionizing radiations exposure, fast protocols and excellent multiplanar imaging in emergency setting, especially in cases in which the diagnosis with US is inconclusive and equivocal. The most frequent cause of non-obstetric acute abdominal pain is appendicitis, followed by inflammatory bowel disease and bowel obstruction, adnexal torsion, cholecystitis and pancreatitis, renal causes like nephrolithiasis and pyelonephritis. Obstetrical causes include the spectrum of placenta accreta, ectopic pregnancy and rare cases of implantation on scar of previous cesarian section and uterine rupture. The aim is to make radiologist familiar with causes of acute abdominal pain in pregnancy and their imaging features

Teaching objectives: - to describe role of MRI findings in the assessment of uterine fibroids; - to review FIGO classification of uterine fibroids; - to provide examples of uterine myoma subtypes; - to indicate the advantages of MRI in imaging of leiomyomas. Review of the topic: Uterine fibroids present the most common benign gynecologic tumours, which arise from smooth muscle cells of the myometrium. They are hormonally dependent tumours, often multiple and asymptomatic. When they occur, symptoms include abnormal uterine bleeding, pain, dysmenorrhea, infertility, or symptoms related to mass effect. Ultrasound presents an initial method, which can be sufficient especially in small and well defined masses. However, MRI provides accurate location, type, number and potential complications of myomas. Furthermore, MRI is effective in case of significant uterine enlargement and presents the problem-solving tool in case of fibroid mimics. Non-degenerated leiomyomas have typical MRI features which include well circumscribed lesions, homogenous iso- or mildly hypointense on T1W and hypointense on T2W MR images (relative to the myometrium). They are hypointense on DWI and ADC maps. After administration of gadolinium, myomas often show early homogenous enhancement similar to the myometrium. Degeneration of leiomyoma include cystic, hemorragic, fatty, hyaline and myxoid changes. The FIGO classification system for uterine fibroids provides uniform assessment and reporting of the localization of myomas. Conclusion: Uterine leiomyomas are frequently seen in clinical practice. Although the US usually presents the initial and most widely available imaging modality, evaluation of myoma is more accurate with MRI. Due to its high tissue resolution and larger field of view, it allows precise localization and characterization of uterine myomas, as well as differentiation from its mimics. Using the FIGO classification system provides a uniform approach in evaluation of uterine fibroids and better communication between radiologists and physicians.

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