Imaging and Decision-Making in Cartilage-Regenerative Surgery Advanced Imaging Technology in radiology, particularly Magnetic Resonance Imaging, has emerged during the last decades and has always been the focus of cartilage repair. The proper treatment indication before surgery and a relevant noninvasive evaluation of the outcome after surgery is essential and can be strongly supported by noninvasive imaging. Additionally, imaging can evaluate and monitor the efficacy of newly developed surgical cartilage repair techniques. The semiquantitative MOCART Score was developed in Vienna 20 years ago and was a hallmark in the systematic morphological analysis of cartilage repair. Moreover, new compositional MR methods such as T2 mapping, dGEMRIC, sodium imaging, gagCEST imaging and diffusion-weighted imaging were developed or improved in Vienna and applied for the first time in patients after cartilage repair surgery. Also, cell-based cartilage repair therapies were applied and studied in Vienna by pioneers in the field and published with partners all over Europe. Austria was also one of the first countries in Europe with a remuneration of ACT in the social system. Five years after our last meeting on imaging and cartilage surgery, we will meet again in Vienna for a Focus Meeting to revisit the latest developments in surgical technology and new imaging scoring systems like MOCART 2.0 on various joints and new advanced compositional MR methods such as texture analysis.