Contrast-enhanced magnetic resonance imaging (MRI), MR spectroscopy, and nuclear medicine sestamibi imaging using technetium-99m methoxyisobutyl isonitrile or positron emission tomography (PET) techniques provide information beyond that of structural imaging by displaying tumor neoangiogenesis, tumor metabolites, increased numbers of tumor cellular mitochondria, and hypermetabolic tumor cells. Much needs to be learned at the molecular level of normal cellular pathways either suppressed or enhanced by tumor-specific molecular changes. These discoveries will allow realization of true individualized patient tumor detection, treatment, and surveillance.