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Imaging plays a crucial role in the diagnosis, characterization, and management of mediastinal tumors. The mediastinal tumors discussed are categorized into anterior mediastinal tumors, including thymic tumors, teratoma/Germ cell tumors, lymphomas, and neurogenic tumors in the posterior mediastinum. Cross sectional imaging with computed tomography (CT) and magnetic resonance imaging (MRI) generates highly detailed images showing the precise location, size, extent of the tumor involvement, as well as its relationship with adjacent critical structures, especially vascular involvement and spinal canal extension, and differentiating solid and cystic masses. Molecular imaging with whole-body positron emission tomography (PET) when combined with CT or MRI can provide valuable information on tumor metabolism, staging, therapy planning, response assessment, and post-treatment monitoring for disease recurrence. With the advent of new non-FDG PET radiopharmaceuticals, the utility of molecular imaging in mediastinal tumors has further broadened. The purpose of this chapter is to provide a clear review of the role, advantages, pitfalls, and advancements of molecular imaging in each mediastinal tumor.
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