In recent years, an increasing number of treatment options have emerged for rectal cancer, ranging from primary surgery to intensified neoadjuvant treatment concepts, usually consisting of a combination of radiotherapy and chemotherapy, to non-surgical treatment strategies (so-called "watch and wait" concept). Due to the multitude of options, however, it is becoming increasingly difficult for the treating physicians to select the optimal therapy option for each individual case based on the usual findings.

It is possible that the combination of MRI together with the metabolic information from FDG-PET can provide helpful additional information. We are therefore currently investigating the value of PET/MRI both in the initial diagnosis and primary therapy decision as well as in the re-evaluation after neoadjuvant therapy and, in particular, in the decision on surgery or non-surgical management ("watch and wait").

After extensive liver resections (so-called major resections), postoperative liver failure is the main cause of postoperative mortality. The occurrence of postoperative liver failure depends on the extent of the resection and the functional liver capacity, which may be limited by pre-existing liver disease (e.g. cirrhosis, fatty liver, etc.) or previous chemotherapy.

The combination of preoperative volumetry with precise measurement of the remaining liver tissue together with liver function scintigraphy (e.g. Tc-99m-HIDA or Tc-99m-mebrofenin) to examine the functional capacity of the remaining liver tissue can provide helpful information to prevent postoperative liver failure. Therefore, the combination of these two examinations is offered in the surgical planning of complex liver interventions (e.g. two-stage liver resections in the so-called ALPPS procedure) and the effect of this advanced surgical planning is being investigated.

Intraoperative resection planning is of crucial importance in minimally invasive or robotic resection of liver tumours, as the surgeon lacks palpatory or manual control. A combination of intraoperative ultrasound directly on the liver surface together with fluorescence imaging using indocyanine green (ICG) and 3D reconstructions of preoperative imaging is therefore used to correctly assess the positional relationship between the tumour and the relevant blood vessels and bile ducts. As a result, it is generally possible to completely remove the tumours while preserving the relevant blood vessels and bile ducts and protecting the tissue.