癌症基因组学和表观基因组学的不断发现彻底改变了临床肿瘤学和精准医疗保健。这些知识为单一肿瘤内、原发性和转移性病变之间以及具有相同组织学类型的癌症患者之间的肿瘤生物学和异质性提供了前所未有的见解。大规模基因组测序研究也引发了新的肿瘤分类、生物标志物和靶向治疗的发展。由于影像学在癌症诊断和治疗中的核心作用，放射科医生需要熟悉基因组学的基本概念，这些概念现已成为肿瘤临床实践的新规范。通过将这些概念融入临床实践，放射科医生可以使他们的影像解释更加有意义和具体，促进多学科临床对话和干预，并提供更好的以患者为中心的护理。这篇综述文章重点介绍了基因组学和表观基因组学的基本概念，回顾了癌症中最常见的遗传改变，并以基于案例的方式讨论了这些概念对器官系统成像的影响。这些信息将有助于刺激成像研究的新创新，加速新成像生物标志物的开发和验证，并推动将新的分子和功能成像方法引入临床放射学。关键词：肿瘤学、癌症基因组学、表观组学、放射基因组学、成像标记 本文提供了补充材料。 © 北美放射学会，2023。

Ongoing discoveries in cancer genomics and epigenomics have revolutionized clinical oncology and precision health care. This knowledge provides unprecedented insights into tumor biology and heterogeneity within a single tumor, among primary and metastatic lesions, and among patients with the same histologic type of cancer. Large-scale genomic sequencing studies also sparked the development of new tumor classifications, biomarkers, and targeted therapies. Because of the central role of imaging in cancer diagnosis and therapy, radiologists need to be familiar with the basic concepts of genomics, which are now becoming the new norm in oncologic clinical practice. By incorporating these concepts into clinical practice, radiologists can make their imaging interpretations more meaningful and specific, facilitate multidisciplinary clinical dialogue and interventions, and provide better patient-centric care. This review article highlights basic concepts of genomics and epigenomics, reviews the most common genetic alterations in cancer, and discusses the implications of these concepts on imaging by organ system in a case-based manner. This information will help stimulate new innovations in imaging research, accelerate the development and validation of new imaging biomarkers, and motivate efforts to bring new molecular and functional imaging methods to clinical radiology. Keywords: Oncology, Cancer Genomics, Epignomics, Radiogenomics, Imaging Markers Supplemental material is available for this article. © RSNA, 2023.