Imaging of autoimmune diseases

Autoimmune diseases represent a heterogeneous group of pathologies with a wide range of immunological changes and clinical presentations. The clinical onset of the disease commonly occurs when signs and symptoms of target tissue hypofunction appear; complications can also be present. The aim of an imaging diagnostic technique in this context is to correctly evaluate the disease extent and severity for appropriate treatment and to follow up the efficacy of therapy. In addition, identification of subjects at risk and the preclinical diagnosis may allow disease prevention. Ultrasound (US), conventional radiology and computed tomography (CT) are often used for a detailed morphological study of tissues involved; magnetic resonance (MRI) may also demonstrate biochemical and structural tissue changes. Nuclear medicine techniques are known for their sensitivity and specificity and in recent years an expanding field is represented by the development of radiolabelled receptor ligands. New radiopharmaceuticals able to bind in vivo to specific receptors have been introduced allowing the non invasive detection of changes in affected tissues. The relevant criteria to choose different diagnostic approaches in several autoimmune diseases are discussed in this review. In particular the role and contribution of nuclear medicine for the study of autoimmune diseases have been described.