生物标志物的发现和开发在检测微小疾病方面越来越受欢迎。然而，需要验证和批准生物标志物，而且很少有生物标志物被临床使用。影像学生物标志物在癌症患者治疗中起着关键作用，因为它们提供有关肿瘤生物学、肿瘤栖息地以及肿瘤在环境中的特征的客观信息。肿瘤对干预的反应变化补充了分子和基因组翻译诊断以及定量信息。神经肿瘤学在诊断和靶向治疗方面变得越来越重要。肿瘤分类一直在积极更新，药物发现和纳米免疫疗法的传递正在靶向治疗研究领域取得进展。开发和使用生物标志物和诊断工具来评估长期存活者的预后或晚期影响非常重要。癌症生物学的改进认识已经将其管理转变为更加注重个性化方法的精准医学。在第一部分中，我们讨论了与疾病课程和特定临床背景有关的生物标志物类别，包括患者和样本都应直接反映目标人群和预期用途的事项。在第二部分中，我们介绍了CT灌注方法，该方法提供了成功应用于临床诊断、治疗和应用的定量和定性数据。此外，新的和有前途的多参数MR成像方法将提供更深入的洞察肿瘤微环境在免疫应答中的作用。此外，我们还简要介绍了基于MRI和PET的新策略，以结合生物信息学和人工智能的应用来汇聚成像生物标志物。在第三部分中，我们简要介绍了精准医学中基于治疗诊断的新方法。这些复杂的技术将可行的标准化融入一个适用的工具中，主要用于诊断实施和跟踪放射性药物以实现个性化医学范式中的治疗。在本文中，我们描述了成像生物标志物表征的关键原则，并讨论了CT、MRI和PET在发现早期疾病成像生物标志物方面的当前状态。 © 2023。作者。

Biomarker discovery and development are popular for detecting the subtle diseases. However, biomarkers are needed to be validated and approved, and even fewer are ever used clinically. Imaging biomarkers have a crucial role in the treatment of cancer patients because they provide objective information on tumor biology, the tumor's habitat, and the tumor's signature in the environment. Tumor changes in response to an intervention complement molecular and genomic translational diagnosis as well as quantitative information. Neuro-oncology has become more prominent in diagnostics and targeted therapies. The classification of tumors has been actively updated, and drug discovery, and delivery in nanoimmunotherapies are advancing in the field of target therapy research. It is important that biomarkers and diagnostic implements be developed and used to assess the prognosis or late effects of long-term survivors. An improved realization of cancer biology has transformed its management with an increasing emphasis on a personalized approach in precision medicine. In the first part, we discuss the biomarker categories in relation to the courses of a disease and specific clinical contexts, including that patients and specimens should both directly reflect the target population and intended use. In the second part, we present the CT perfusion approach that provides quantitative and qualitative data that has been successfully applied to the clinical diagnosis, treatment and application. Furthermore, the novel and promising multiparametric MR imageing approach will provide deeper insights regarding the tumor microenvironment in the immune response. Additionally, we briefly remark new tactics based on MRI and PET for converging on imaging biomarkers combined with applications of bioinformatics in artificial intelligence. In the third part, we briefly address new approaches based on theranostics in precision medicine. These sophisticated techniques merge achievable standardizations into an applicatory apparatus for primarily a diagnostic implementation and tracking radioactive drugs to identify and to deliver therapies in an individualized medicine paradigm. In this article, we describe the critical principles for imaging biomarker characterization and discuss the current status of CT, MRI and PET in finiding imaging biomarkers of early disease.© 2023. The Author(s).