Imaging biomarkers need clear definitions, reliable measurement and visible validation to support use across research, regulatory and clinical settings. Current inventories vary in how they record clinical context, technical details, evidence, regulation and provenance. A recent analysis published in Insights into Imaging sets out a standardised catalogue based on Findable, Accessible, Interoperable and Reusable principles. The framework groups key descriptors into core identification, clinical context, imaging and technical information, validation and administrative data, aiming to make biomarker information easier to discover, compare and reuse.
A Common Structure for Biomarker Description
The catalogue centres on the variables needed to describe imaging biomarkers in a consistent way, rather than on producing a simple list of available markers. Its structure brings together information from scientific literature, regulatory sources and established biomarker resources, then organises the resulting descriptors into a unified format. The aim is to support comparison across diseases, organs and imaging techniques while preserving the clinical meaning of each biomarker.
The final structure groups descriptors into five broad domains. Core identification covers the biomarker name, its surrogate meaning and its clinical relevance. Clinical context covers its main clinical role, organ or organs, disease or substrate, ranges and actionability. Imaging and technical information covers modality, acquisition approach, technical requirements, extraction method, association type, dimensionality and units. Validation covers support from publications, professional societies and regulatory qualifications. Administrative data covers repository information and version or author tracking.
The catalogue also simplifies functional classification. Instead of keeping multiple overlapping categories as separate fields, it consolidates biomarker roles into diagnostic, prognostic, predictive and response categories. Monitoring falls within response, safety falls within predictive use and susceptibility or risk falls within prognostic use. This keeps the structure compatible with established terminology while reducing duplication.
Examples Show Cross-Modality Application
The catalogue structure applies to several inflammatory disease contexts. Examples include apparent diffusion coefficient in bowel inflammation, fluorodeoxyglucose positron emission tomography uptake metrics in large vessel vasculitis, computed tomography-based radiomics signatures in systemic sclerosis-associated interstitial lung disease and Doppler ultrasound vascularity index in rheumatoid arthritis. These examples cover magnetic resonance imaging, nuclear medicine, computed tomography and ultrasound, and they include both single measurements and composite model-derived indicators.
Some descriptors remain stable across clinical contexts. These include the biological process represented by the biomarker, imaging modality, acquisition method, extraction process, association type, dimensionality, units and repository availability. Apparent diffusion coefficient reflects water movement in tissues and relates to microstructural changes. Fluorodeoxyglucose positron emission tomography uptake reflects metabolic activity. Radiomics signatures capture patterns of tissue heterogeneity. Doppler ultrasound vascularity index reflects synovial microvascular flow.
The technical fields make the measurement process more transparent. Apparent diffusion coefficient relies on diffusion-weighted magnetic resonance imaging and a fitting method. Uptake metrics in positron emission tomography use tissue activity in relation to injected dose and body weight. Radiomics features rely on standardised feature definitions and modelling approaches. Doppler vascularity index uses the proportion of colour Doppler signal within a selected region. These technical descriptors help clarify how a biomarker value is generated without requiring every use case to repeat the same underlying information.
Context Remains Central to Clinical Meaning
The same biomarker can have different implications depending on disease, organ and clinical question. In Crohn’s disease, apparent diffusion coefficient values tend to be lower in inflamed bowel segments. In large vessel vasculitis, fluorodeoxyglucose positron emission tomography uses vascular uptake in relation to liver uptake to identify active inflammation. In systemic sclerosis-associated interstitial lung disease, radiomics models use composite scores and cut-offs derived from development and validation cohorts. In rheumatoid arthritis, Doppler ultrasound vascularity indices quantify synovial vascularisation to assess inflammatory activity.
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The examples also show how endorsement and regulatory information can be captured without overstating clinical status. Apparent diffusion coefficient aligns with QIBA work on diffusion-weighted magnetic resonance imaging standardisation. Fluorodeoxyglucose positron emission tomography in large vessel vasculitis aligns with joint procedural recommendations from EANM, SNMMI and the PET Interest Group, with ASNC endorsement. Doppler ultrasound connects with EULAR and OMERACT ultrasound frameworks. No formal regulatory qualifications apply to the inflammatory contexts presented.
The catalogue addresses a wider problem of fragmentation. Current information on imaging biomarkers often sits across publications, inventories and technical standards, with differences in the level of detail and the fields used. Some resources focus mainly on technical performance, while others classify biomarkers by disease or modality. The unified format adds clinical context, technical derivation, validation, regulatory status and governance information within one structure. It also supports versioning and traceability, which matter because biomarker inventories can evolve over time.
A standardised imaging biomarker catalogue can make biomarker information more comparable, traceable and reusable across clinical, research and regulatory settings. The framework keeps clinical relevance, technical derivation, evidence, endorsement and administrative tracking within a single structure. It complements existing biomarker initiatives by adding a domain-independent format for describing imaging biomarkers across organs and diseases. Further work focuses on external validation, refinement through user feedback and pilot implementation in clinical and research environments.
Source: Insights into Imaging
Image Credit: iStock
References:
Rodríguez-Belenguer P, Doria-Borrell P, Alberich-Bayarri Á et al. (2026) Toward a standardized and interoperable imaging biomarker catalog. Insights Imaging; 17, 156.
