The Microbiome–Imaging Axis: Can Radiology Detect Microbial Influences on Disease?

The microbiome–imaging axis, or radio microbiomics, is an emerging field that combines medical imaging with gut microbiome analysis to map how the gut communicates with distant organs, particularly the brain. While traditional research often focuses on simple correlations, this framework uses structural and functional imaging to visualize the actual physical impact of gut dysbiosis on host tissue. This review explores how microbial metabolites, such as short-chain fatty acids (SCFAs) and bile acids, act as molecular messengers that trigger changes in brain connectivity, cortical thickness, and liver fat deposition. We examine the clinical utility of these findings as non-invasive biomarkers for Alzheimer’s disease, Multiple Sclerosis, and NAFLD. Additionally, we discuss the development of pathogen-specific PET tracers that allow doctors to see active infections directly, rather than just the body’s inflammatory response.