Imaging tools may help diagnose, monitor and treat diseases earlier. Imaging biomarkers have unique advantages and limitations compared to other biomarkers. They provide information on the exact site of the disease, are relatively non-invasive and allow follow-up. However unlike biospecimens or physiological measurements, the quality and validity of imaging measurements as biomarkers commonly depends on the use and technical characteristics of the diagnostic imaging device, and in some cases also on the expertise of the operator as well. Moreover, for many imaging biomarkers, standardisation of acquisition and analysis as well the identification of objectively measured characteristics poses additional concerns. Nonetheless imaging biomarkers have the potential to detect and monitor rheumatic diseases as well as predict response to treatment. In order to qualify, an imaging biomarker has to be accurate, reproducible, standardized and suitable for multicenter evaluation and needs to demonstrate correlation with either anatomy/pathology or with other imaging modalities. Furthermore, in order to be used as a predictive biomarker, it needs to be closely linked to the success or failure of the therapeutic effect and with the clinical outcome relevant to the disease.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.6322