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To review new putative mechanisms involved in the pathophysiology of a disturbed energy balance in cancer cachexia, which can lead to novel targets for clinical cachexia management. In the context of rapid developments in tumour treatment with potential systemic consequences, this article reviews recent data on energy requirements. Furthermore, we focus on new insights in brown adipose tissue (BAT) activity and reward processing in the brain in relation to the cachexia process.Nearly no new data have been published on energy requirements of cancer patients in the light of comprehensive new therapies in oncology. New developments, such as the introduction of staging with 18F-fluorodeoxyglucose PET-computed tomography scanning, led to the observation that BAT activation may contribute to impaired energy balance in cancer cachexia. Animal and human data to date provide an indication that BAT activation indeed occurs, but its quantitative impact on the degree of cachexia is controversial. The peripheral and central nervous system is known to influence satiation, with a possible role for impaired food reward processing in the brain. To date, there are limited confirmatory data, but this is an interesting new area to explore for better understanding and treating cancer-induced anorexia.The multimodal approach to counteract cancer cachexia should expand its targets to BAT and food reward processing in the brain.

PurposeTo explore the use of PINS radiofrequency (RF) pulses to reduce RF power deposition in multiband/simultaneous multislice imaging with the RARE/turbo spin echo (TSE) sequence at 3T and 7T.MethodsA PINS‐TSE sequence was implemented and combined with blipped CAIPI to improve the reconstruction of superposed slices. Whole brain imaging of healthy volunteers was performed at both 3T and 7T using a 32‐channel coil for signal reception.ResultsA considerable reduction in power deposition was achieved compared with a standard sequence of the manufacturer. At 3T, the reduction in specific absorption rate (SAR) made short pulse repetition times (TRs) possible, however, in order to obtain a good T2 contrast, it is advisable to maintain TR while extending the echo train length. At 7T, whole brain coverage with a spatial resolution of 1 × 1 × 2 mm3 was achieved in an acquisition time of 150 s. Furthermore, it could be shown that pulse sequences that use PINS pulses do not suffer from having additional magnetization transfer contrast.ConclusionPINS RF pulses combined with multiband imaging reduce SAR sufficiently to enable routine TSE imaging at 7T within clinically acceptable acquisition times. In general, the combination of multiband imaging with PINS RF pulses represents a method to reduce total RF power deposition. Magn Reson Med 71:44–49, 2014. © 2013 Wiley Periodicals, Inc.