Advances in Imaging and Multimodal Biomarkers in Systemic Autoimmune Rheumatic Diseases.

Systemic autoimmune rheumatic diseases (SARDs), including systemic sclerosis, systemic lupus erythematosus and idiopathic inflammatory myopathies, are characterised by substantial clinical and biological heterogeneity, with variable disease trajectories, patterns of organ and musculoskeletal involvement and responses to treatment. The identification and validation of reliable biomarkers, including imaging biomarkers, are therefore central to improving early disease identification, risk stratification, assessment of disease activity and organ involvement, prediction of disease progression, and monitoring and prediction of treatment response.Biomarkers in SARDs encompass an increasingly diverse range of modalities. Diagnostic imaging plays a growing role, with magnetic resonance imaging (MRI), computed tomography (CT), ultrasound, nuclear medicine imaging (PET, SPECT) and nailfold videocapillaroscopy enabling non-invasive assessment of muscle, joint, bone, vascular and organ involvement. These are complemented by conventional and novel serological markers, cellular and immunological signatures, and molecular and multi-omics profiles. Developments in advanced and quantitative imaging, artificial intelligence-based image analysis and high-dimensional molecular profiling are providing new opportunities to characterise disease mechanisms and identify subclinical organ involvement, while longitudinal assessment may facilitate earlier recognition of disease progression and treatment response.However, despite the rapid expansion of biomarker research, translation into routine clinical practice remains limited. Many candidate biomarkers, including imaging parameters, lack external and longitudinal validation, standardised acquisition protocols and thresholds, or evidence of incremental clinical utility over existing assessment strategies. In addition, individual biomarkers may be insufficient to capture the biological and clinical complexity of SARDs. Increasing attention is therefore being directed towards multimodal approaches that integrate imaging findings with clinical, serological, cellular, molecular and microvascular biomarkers to improve prediction and enable more individualised patient management.Addressing these challenges is essential to move the field from biomarker discovery towards validation, clinical implementation and precision medicine.This Research Topic aims to bring together current and emerging research on imaging and multimodal biomarkers across systemic autoimmune rheumatic diseases, spanning biomarker discovery, validation and clinical translation.The collection will place particular emphasis on diagnostic imaging and microvascular biomarkers, while also considering clinical, serological, cellular, immunological and molecular biomarkers, especially where these are evaluated alongside or in correlation with imaging findings. Studies may address different stages of disease and organ manifestations, with particular interest in biomarkers for early disease and organ involvement, disease activity and stratification, prediction of progression and prognosis, and treatment response.The Research Topic will also explore the integration of imaging with other biomarker modalities into predictive models and precision-medicine approaches. By bringing together research across diseases, organ systems and biomarker platforms, the collection aims to identify opportunities for cross-disease learning, address current barriers to biomarker validation and standardisation, and facilitate translation of promising biomarkers into clinically meaningful tools.We welcome original research, systematic reviews, mini-reviews, perspectives and methods papers addressing, but not limited to, the following themes:-Imaging biomarkers, including MRI, CT, ultrasound, radiography and PET/SPECT, for the detection, characterisation and monitoring of musculoskeletal, vascular and organ involvement (e.g. myositis, arthritis, enthesitis, calcinosis and interstitial lung disease).-Microvascular biomarkers, including nailfold videocapillaroscopy and other techniques for assessing vascular involvement.-Artificial intelligence, radiomics and quantitative image analysis for diagnosis, disease stratification and prediction of outcomes.-Bone health assessment, including bone mineral density measurement by DXA and quantitative CT in patients with SARDs and those receiving long-term glucocorticoid therapy.-Organ-specific biomarkers for pulmonary, cardiovascular, renal, vascular and musculoskeletal involvement, including biomarkers for the development and progression of interstitial lung disease.-Biomarkers of disease activity and progression, including imaging-based assessment of inflammation and damage, and prediction of disease flares, organ damage and long-term clinical outcomes.-Predictive biomarkers of treatment response and therapeutic outcomes, including imaging and other biomarkers that may support treatment selection, monitoring and personalised therapeutic strategies.-Serological, cellular, immunological and molecular biomarkers for diagnosis, early disease identification, disease stratification and prognosis, particularly in relation to imaging findings.-Novel technologies and multi-omics approaches for biomarker discovery, including genomics, transcriptomics, proteomics, metabolomics and high-dimensional cellular profiling, and their integration with imaging data.-Multimodal biomarker integration and predictive modelling, combining imaging, clinical, serological, molecular and microvascular information to improve risk stratification and precision medicine.-Biomarker validation and standardisation, including standardised imaging protocols, external and longitudinal validation, reproducibility, clinically meaningful thresholds and evaluation across diverse patient populations and clinical settings.-Translation of biomarkers into clinical practice, including their integration into clinical decision-making, precision-medicine strategies and treat-to-target approaches.If you are interested in submitting or have any questions please contact the journal email: musculoskeletaldisorders@frontiersin.org Topic editors: Cristiana Sieiro Santos, Alvaro Gomez, Sarah Dyball Source: https://www.frontiersin.org/research-topics/85101/advances-in-imaging-and-multimodal-biomarkers-in-systemic-autoimmune-rheumatic-diseases