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Functional MRI has leaped pass being only an exotic research tool in radiotherapy. Certain functional MRI techniques have in fact become an integrated part of the imaging protocol in the planning phase, for various indication. Furthermore, with the recent introduction of hybrid MRI-linac systems, enabling on-line MRI-guided radiotherapy, the clinical research potential of functional MRI has increased dramatically. This is splendid news, not only for radiotherapy, but also for the MRI-community, as this endeavor inevitably leads to optimization of existing techniques and development of new ones. Furthermore, new insight into the correlation between image and the underlying biology is expected.

But what is functional MRI? – Which are the most common techniques, and which are in the forefront of emerging techniques, for use in radiotherapy? Moreover, what is the current role of functional MRI in radiotherapy and what clinical potential does it carry, and how can we unleash it?