Microelectronics is emerging, sometimes with changing fortunes, as a key enabling technology in diagnostics. This paper reviews some recent results and technical challenges which still need to be addressed in terms of the design of CMOS analog application specific integrated circuits (ASICs) and their integration in the surrounding systems, in order to consolidate this technological paradigm. Open issues are discussed from two, apparently distant but complementary, points of view: micro-analytical devices, combining microfluidics with affinity bio-sensing, and gamma cameras for simultaneous multi-modal imaging, namely scintigraphy and magnetic resonance imaging (MRI). The role of integrated circuits is central in both application domains. In portable analytical platforms, ASICs offer miniaturization and tackle the noise/power dissipation trade-off. The integration of CMOS chips with microfluidics poses multiple open technological issues. In multi-modal imaging, now that the compatibility of the acquisition chains (thousands of Silicon Photo-Multipliers channels) of gamma detectors with Tesla-level magnetic fields has been demonstrated, other development directions, enabled by microelectronics, can be envisioned in particular for single-photon emission tomography (SPECT): a faster and simplified operation, for instance, to allow transportable applications (bed-side) and hardware pre-processing that reduces the number of output signals and the image reconstruction time.