Fibrosis plays an important role in many different pathologies. It results from tissue injury, chronic inflammation, autoimmune reactions and genetic alterations, and it is characterized by the excessive deposition of extracellular matrix components. Biopsies are routinely employed for fibrosis diagnosis, but they suffer from several drawbacks, including their invasive nature, sampling variability and limited spatial information. To overcome these limitations, multiple different imaging tools and technologies have been evaluated over the years, including X-ray imaging, computed tomography (CT), ultrasound (US), magnetic resonance imaging (MRI), positron emission tomography (PET) and single-photon emission computed tomography (SPECT). These modalities can provide anatomical, functional and molecular imaging information which is useful for fibrosis diagnosis and staging, and they may also hold potential for the longitudinal assessment of therapy responses. Here, we summarize the use of non-invasive imaging techniques for monitoring fibrosis in systemic autoimmune diseases, in parenchymal organs (such as liver, kidney, lung and heart), and in desmoplastic cancers. We also discuss how imaging biomarkers can be integrated in (pre-) clinical research to individualize and improve anti-fibrotic therapies.

纤维化在许多不同的病理学中起重要作用。它由组织损伤、慢性炎症、自身免疫反应和基因改变引起，其特征是细胞外基质成分的过度沉积。活检通常用于纤维化诊断，但它们有几个缺点，包括它们的侵入性、采样可变性和有限的空间信息。为了克服这些限制，多年来已经评估了多种不同的成像工具和技术，包括 X 射线成像、计算机断层扫描 (CT)、超声 (US)、磁共振成像 (MRI)、正电子发射断层扫描 (PET) 和单-光子发射计算机断层扫描（SPECT）。这些方式可以提供解剖学、功能和分子成像信息对纤维化诊断和分期很有用，它们也可能具有对治疗反应进行纵向评估的潜力。在这里，我们总结了使用非侵入性成像技术来监测系统性自身免疫性疾病、实质器官（如肝、肾、肺和心脏）和促纤维细胞癌中的纤维化。我们还讨论了如何将成像生物标志物整合到（预）临床研究中，以个性化和改进抗纤维化治疗。