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Combination of Imaging and Biomarkers - Advantages in Gastroenterology

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The combination of imaging and biomarkers in gastroenterology has led to precise diagnosis, encouraging early intervention and better life quality.

Written by

Dr. Suhaila

Medically reviewed by

Dr. Kaushal Bhavsar

Published At April 23, 2024
Reviewed AtApril 23, 2024


With the advent of new emerging technologies, modern healthcare has entered an era of precise and efficient medicine. Among these are advances in diagnostic systems like the combination of biomarkers and imaging technologies. This integration has become a powerful tool in medical practice. This offers refined diagnosis, transforms treatment practices, and improves patient outcomes. In the specialized field of gastroenterology, this amalgamation has revolutionized a new era of precise diagnosis, localization of diseases, and further strengthening patient care. This article explores the importance of combined imaging and biomarkers, highlighting their importance and effectiveness.

What Is the Role of Imaging in Gastrointestinal Health?

Imaging has evolved significantly, helping clinicians assess the digestive system's structure and function. Various imaging modes, such as endoscopy, computed tomography, magnetic resonance imaging, and ultrasound, have been used. The selection of a particular mode depends on the chief complaint, symptoms, suspected probable diagnosis, and what information is further needed for confirmatory diagnosis.

  • Endoscopy: With its flexible tube fitted with a light and camera, this device has excelled in traditional methods. Its applications go beyond detecting diseases; they are also used to procure biopsy specimens and, to some extent, as a therapeutic modality. The real-time visualization it provides has become very popular in most gastrointestinal anomalies.

  • Computed Tomography: Cross-section imaging mainly helps visualize organs and tissues. It is also an important tool for assessing trauma and injury and is frequently used in staging liver diseases. A detailed sectional image lets the clinician determine the size and extent of any mass or disease and plan the best surgery or treatment.

  • Magnetic Resource Imaging: This method utilizes magnetic waves. This helps visualize all ducts and provides minute details of any inflammatory disease in the bowel. Unlike other radiological X-rays, this method is non-invasive and has excellent soft tissue imaging capabilities. It can also provide multidimensional images, which help comprehensively study the structure and disease.

  • Ultrasound: High-frequency sound waves are used in ultrasound evaluations to evaluate the liver and gallbladder. They are also utilized to explore any mass in the stomach, offering real-time disease assessment. Ultrasound is easy to perform, moves the machine around, and is cost-effective compared to other diagnostics. This method is most commonly used in routine clinical practice.

What Is the Role of Biomarkers in Gastrointestinal Health?

Biomarkers play a crucial role in gastroenterology by informing the system about what is happening. The body releases certain fluids or molecular indicators which can be used for this purpose.

  • Fecal Calprotectin: This protein is released by neutrophils and is measured in stool. This serves as an indicator of intestinal inflammation. Its main significance is that it can help distinguish between inflammatory and non-inflammatory conditions. Fecal calprotectin helps diagnose and is an important marker for assessing treatment response in inflammatory bowel disease.

  • C-Reactive Protein: C-reactive protein is an acute-phase reactant produced in response to liver inflammation. Elevated levels in the blood may indicate various disorders. It is an important marker used to assess disease activity and monitor treatment response.

  • Carcinoembryonic Antigen: This is a glycoprotein originally present in fetal tissues. In adults, it is mainly used as a cancer marker, aiding in monitoring disease progress and early detection of recurrence. When these antigens specific for colorectal cancer are used, they are valuable tools to assess outcomes and guide further treatment.

  • Liver Function Tests: These are blood tests that show the health and function of the liver. The liver's ability to metabolize and eliminate waste products is assessed; they are most commonly prescribed to diagnose and monitor ongoing conditions. They include a comprehensive set of markers like alanine aminotransferase, bilirubin, albumin, total protein, prothrombin time, international normalized ratio, alkaline phosphatase, and aspartate aminotransferase. This helps diagnose liver issues and current functional status and detect disorders early. Abnormal results in any of these markers may necessitate further investigations and tests, guiding clinicians to help improve liver health.

What Are the Advantages of Combining Both?

A combined approach is necessary as the biomarkers provide insight into what is wrong in the body by their altered levels. In contrast, imaging helps provide better localization and visualization of the area.

  • Early Diagnosis: While imaging aims to help clinicians visualize structural aspects, biomarkers provide information on functional changes. For example, when combined with imaging, elevated cancer biomarkers can pinpoint diseases at early stages, encouraging early treatment and therapy and reducing the disease burden.

  • Comprehensive Analysis: The fusion of macroscopic imaging visuals and microscopic biomarkers insights allows a better view of gastrointestinal organs. This helps in the characterization and diagnosis of diseases. For example, in colon cancer, combining endoscopy along with assessing Carcinoembryonic Antigen levels offers information on the aggressive nature of the disease.

  • Monitoring: Once the treatment is started, imaging and biomarkers help assess changes at the molecular level, improving the efficacy of the treatment and advocating required changes for better effects. For example, in chronic liver diseases, imaging shows the architecture, and liver function tests assess and help guide if medication adjustments are needed.

  • Reduced Number of Procedures and Cost Effective: The combined use of imaging and biomarkers requires invasive procedures like multiple endoscopes, which provide non-invasive alternatives to monitor the disease. This reduces patient visits and discomfort, creates a better experience, and is cost-effective.

  • Personalized Treatment Approach: The merging of imaging and biomarkers helps tailor treatment plans, Considering the individual's unique characteristics of present health.

  • Improved Disease Staging: The enhancement in the sensitivity and specificity achieved by using this combination of imaging and biomarkers has contributed to a more accurate and precise disease staging. For example, in liver diseases, imaging will show fibrosis, and biomarkers will help assess the changes at the molecular level and to what extent they are present, providing a better guide for diagnosis.


The joint use of biomarkers and imaging represents an advanced medical practice. This approach offers great benefits for accurate diagnosis. By providing visualization theory imaging and molecular characterization of biomarkers, these testing modalities have changed the healthcare system towards early detection and personalized treatment plans.

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Dr. Kaushal Bhavsar
Dr. Kaushal Bhavsar

Pulmonology (Asthma Doctors)


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