Human kind receives more than 90% of its environmental informations by the visual sense. Consequently, acquiring visual informations by imaging procedures has gained increasing importance in medical diagnostics or therapy. As functional parameters plays an essential role in surgical planning, preoperative simulation of postoperative function will also have an increasing influence on surgical planning and will be one of the future challenges in medicine.

In evaluation of the musculosceletal system, a break through was achieved by 3D-representation of the imaging data. New possibilities have been achieved like individual 3D-planning of osteotomies including soft tissue outcome or manufacturing individual custom implants for scull reconstruction. By modern multidetector scanner and rapid evolution of computer multiprocessor technology it was possible not only to improve the spatial 3D-image resolution but also to fasten scanning time and to achieve realtime online imaging, so called 4D-imaging.

New possibilities of 4D-imaging will be presented like realtime-MRI (30 images/s) for pre- and postoperative control of eye movements after orbital reconstruction or representation of muscle function in speech before and after surgery. Planning of facial expressions after aesthetic surgery will be possible by 4D-surface scanning and 4D-computertomography of the facial scull enables not only realtime representation of the TMJ movements of condyle and disc but also representation the muscle functions.

It will be shown, that these new diagnostic imaging tools can directly led to surgical innovations like development of new surgical devices. Intraoperative imaging offers new therapeutic options or options in controlling and optimizing surgery.