As the drug development pipeline for Duchenne muscular dystrophy (DMD) rapidly 
advances, clinical trial outcomes need to be optimized. Effective assessment of 
disease burden, natural history progression, and response to therapy in clinical 
trials for Duchenne muscular dystrophy are critical factors for clinical trial 
success. By choosing optimal biomarkers to better assess therapeutic efficacy, 
study costs and sample size requirements can be reduced. Currently, functional 
measures continue to serve as the primary outcome for the majority of DMD 
clinical trials. Quantitative measures of muscle health, including magnetic 
resonance imaging and spectroscopy, electrical impedance myography, and 
ultrasound, sensitively identify diseased muscle, disease progression, and 
response to a therapeutic intervention. Furthermore, such non-invasive 
techniques have the potential to identify disease pathology prior to onset of 
clinical symptoms. Despite robust supportive evidence, non-invasive quantitative 
techniques are still not frequently utilized in clinical trials for Duchenne 
muscular dystrophy. Non-invasive quantitative techniques have demonstrated the 
ability to quantify disease progression and potential response to therapeutic 
intervention, and should be used as a supplement to current standard functional 
measures. Such methods have the potential to significantly accelerate the 
development and approval of therapies for DMD.