(CAD) 'Computer aided detection' or 'computer assisted diagnosis' systems are tools to improve the efficiency and workflow in medical imaging procedures. The aim of CAD is to increase the diagnostic accuracy of screening procedures by using a computer system to locate abnormalities, improve image management, correct patient movement and assist the radiologists in the interpretation and analysis of data-intensive studies. Typical applications include the tumor detection in mammography, breast MRI, colonography, and lung imaging. Newer applications like prostate MRI are under investigation.

See also MR Guided Interventions, Breast MRI and Hybrid Imaging.

Contrast enhanced MRI is a commonly used procedure in magnetic resonance imaging. The need to more accurately characterize different types of lesions and to detect all malignant lesions is the main reason for the use of intravenous contrast agents.
Some methods are available to improve the contrast of different tissues. The focus of dynamic contrast enhanced MRI (DCE-MRI) is on contrast kinetics with demands for spatial resolution dependent on the application. DCE-MR imaging is used for diagnosis of cancer (see also liver imaging, abdominal imaging, breast MRI, dynamic scanning) as well as for diagnosis of cardiac infarction (see perfusion imaging, cardiac MRI). Quantitative DCE-MRI requires special data acquisition techniques and analysis software.
Contrast enhanced magnetic resonance angiography (CE-MRA) allows the visualization of vessels and the temporal resolution provides a separation of arteries and veins. These methods share the need for acquisition methods with high temporal and spatial resolution.
Double contrast administration (combined contrast enhanced (CCE) MRI) uses two contrast agents with complementary mechanisms e.g., superparamagnetic iron oxide to darken the background liver and gadolinium to brighten the vessels. A variety of different categories of contrast agents are currently available for clinical use.
Reasons for the use of contrast agents in MRI scans are:
Common Indications:
Brain MRI : Preoperative/pretreatment evaluation and postoperative evaluation of brain tumor therapy, CNS infections, noninfectious inflammatory disease and meningeal disease.
Spine MRI : Infection/inflammatory disease, primary tumors, drop metastases, initial evaluation of syrinx, postoperative evaluation of the lumbar spine: disk vs. scar.
Breast MRI : Detection of breast cancer in case of dense breasts, implants, malignant lymph nodes, or scarring after treatment for breast cancer, diagnosis of a suspicious breast lesion in order to avoid biopsy.

For Ultrasound Imaging (USI) see Contrast Enhanced Ultrasound at Medical-Ultrasound-Imaging.com. See also Blood Pool Agents, Myocardial Late Enhancement, Cardiovascular Imaging, Contrast Enhanced MR Venography, Contrast Resolution, Dynamic Scanning, Lung Imaging, Hepatobiliary Contrast Agents, Contrast Medium and MRI Guided Biopsy.

(MRI-CA, MRCA) The noninvasive imaging of the coronary arteries using magnetic resonance imaging of the heart.
For cardiac MRI-CA, high performance machines are necessary with minimum 40mT/m and 300μsec slew rate.
2D and 3D acquisition are used for fast gradient echo sequences with techniques for minimizing cardiac and respiratory motion and suppressing the high signal of pericardial fat. The optimal sequences seem to be trueFISP, Balanced FFE or FIESTA with SMASH and SENSE techniques. Respiratory motion is minimized for 3D acquisitions by using respiratory gating, especially using navigator echoes (Navigator Technique) to track diaphragmatic and cardiac movement. Optimization of MR technique can provide mapping of long segments of the coronary arteries.
Blood pool agents are being applied to improve the reliability of coronary MR angiography. The major current clinical indication is the identification of coronary artery anomalies because the diagnostic accuracy's for identifying haemodynamically significant stenoses are variable depending of the image quality.

See also Magnetic Resonance Angiography, and Cardiac MRI.

The Dixon technique is a MRI method used for fat suppression and/or fat quantification. The difference in magnetic resonance frequencies between fat and water-bound protons allows the separation of water and fat images based on the chemical shift effect.
This imaging technique is named after Dixon, who published in 1984 the basic idea to use phase differences to calculate water and fat components in postprocessing. Dixon's method relies on acquiring an image when fat and water are 'in phase', and another in 'opposed phase' (out of phase). These images are then added together to get water-only images, and subtracted to get fat-only images. Therefore, this sequence type can deliver up to 4 contrasts in one measurement: in phase, opposed phase, water and fat images. An additional benefit of Dixon imaging is that source images and fat images are also available to the diagnosing physician.
The original two point Dixon sequence (number of points means the number of images acquired at different TE) had limited possibilities to optimize the echo time, spatial resolution, slice thickness, and scan time; but Dixon based fat suppression can be very effective in areas of high magnetic susceptibility, where other techniques fail. This insensitivity to magnetic field inhomogeneity and the possibility of direct image-based water and fat quantification have currently generated high research interests and improvements to the basic method (three point Dixon).
The combination of Dixon with gradient echo sequences allows for example liver imaging with 4 image types in one breath hold. With Dixon TSE/FSE an excellent fat suppression with high resolution can be achieved, particularly useful in imaging of the extremities.
For low bandwidth imaging, chemical shift correction of fat images can be made before recombination with water images to produce images free of chemical shift displacement artifacts. The need to acquire more echoes lengthens the minimum scan time, but the lack of fat saturation pulses extends the maximum slice coverage resulting in comparable scan time.

Dotarem® is a paramagnetic ionic MRI contrast agent. Extracellular contrast agents like Dotarem®, can be bolus injected because of the relatively low rate of side effects. This contrast medium is useable to enhance signal intensity in magnetic resonance imaging for intracranial and spinal lesions with an abnormal blood brain barrier or abnormal vascularity, and in whole body imaging.

WARNING: NEPHROGENIC SYSTEMIC FIBROSIS Gadolinium-based contrast agents increase the risk for nephrogenic systemic fibrosis (NSF) in patients with acute or chronic severe renal insufficiency (glomerular filtration rate less than 30 mL/min/1.73m²), or acute renal insufficiency of any severity due to the hepato-renal syndrome or in the perioperative liver transplantation period.