Heart failure & cardiomyopathiesDiagnostic or prognostic study

Comparison of 18F-FAPI-42 Positron Emission Tomography (PET) for Detecting Cardiac Fibroblast Activation in Dilated Cardiomyopathy With Histopathology and CMR

JACC Cardiovasc ImagingPublished

  • Diagnostic imaging feasibility study

Authors' conclusion

18F-FAPI PET is capable of detecting fibroblast activation in the myocardium of DCM, strongly correlating with histological markers and cardiac function parameters.

Study context

Population
Patients with dilated cardiomyopathy (DCM)14 also PET/CMR
Participants
19 patients
Comparison
18F-FAPI-42 PET vs CMR and histopathology
  • DCMn = 19
Outcome
Feasibility of 18F-FAPI-42 PET for detecting myocardial fibroblast activation and fibrosis

Performance

As reported in the abstract

Test or modelAbnormal segments
18F-FAPI-42 PET168
CMR-LGE95

Further findings

Correlation with histology (heart transplant patients)

FAPI uptake strongly correlated with fibroblast activation protein (FAP) mean fluorescence intensity
P < 0.001
FAPI uptake correlated with collagen fiber deposition
P < 0.05
  • 4 patients transplanted 9 to 124 days after PET

Correlation with CMR function parameters

FAPI uptake correlated with ESV, EDV, LVEF % and ECV %

By NYHA class (Ⅱ to Ⅳ)

Metabolically active volume increased consistently
SUVmax and total lesion FAPI increased then declined

Original publication

Comparison of 18F-FAPI-42 PET for Detecting Cardiac Fibroblast Activation in Dilated Cardiomyopathy With Histopathology and CMR. JACC Cardiovasc Imaging. Published 30 July 2025. doi:10.1016/j.jcmg.2025.05.021

Summarised from the published abstract; every number is checked against it