RADIOLOGIC BIOMARKERS IN LIFESTYLE MEDICINE: IMAGING AS AN OBJECTIVE ENDPOINT OF BEHAVIORAL INTERVENTIONS

Background: Lifestyle medicine relies on behavioral interventions to prevent and reverse chronic disease, yet outcome measurement often depends on self-reported data, serum biomarkers, or long-term clinical endpoints requiring years of follow-up. Advanced imaging modalities offer objective, organ-specific, and quantifiable surrogate endpoints that can detect structural changes over clinically relevant timeframes of 6-24 months. Objective: To synthesize current evidence on radiologic biomarkers across four disease domains-metabolic dysfunction-associated steatotic liver disease (MASLD), atherosclerosis, osteoporosis, and sarcopenia-that demonstrate responsiveness to lifestyle interventions, and to propose a practical Imaging-Guided Lifestyle Medicine (IGLM) framework for clinical and research application.