New PET/CT imaging technique enables early detection of multiple forms of cardiomyopathy

A new PET/CT imaging technique that visualizes activated fibroblasts in the heart muscle enables early detection of multiple forms of cardiomyopathy, according to research presented at the Society of Nuclear Medicine and Molecular Imaging 2025 Annual Meeting. By targeting fibroblast activation-an early indicator of myocardial fibrosis-this method provides valuable insights into disease progression and helps improve risk stratification for patients with non-ischemic cardiomyopathy.

Diagnosing non-ischemic cardiomyopathy (heart muscle diseases that are not caused by blocked coronary arteries) usually involves blood tests, heart ultrasound, cardiac MRI scans, and sometimes a heart tissue biopsy. However, these diagnostics approaches have limitations.

Blood tests, ultrasounds, and MRIs often fail to detect the earliest changes in cardiomyopathy, when fibroblasts activate and start the scarring process. Since early detection is crucial for the best patient outcomes, our study focused on evaluating a molecular imaging technique capable of identifying these very first signs of fibroblast activation."

Qiao Yang, MD, researcher, Department of Nuclear Medicine, Peking Union Medical College Hospital in Beijing, China

Fifty patients with various types of non-ischemic cardiomyopathy underwent ⁶⁸Ga-FAPI PET/CT scans to measure heart fibroblast activity. Key imaging measures-such as left ventricular molecular volume and standardized uptake values-were calculated. Researchers also collected blood biomarkers and heart ultrasound data, including markers of heart stress and function. They then analyzed how the PET scan results related to these clinical and echocardiographic measures.

PET/CT scans using ⁶⁸Ga-FAPI detected activated fibroblasts in 64 percent of patients, with half showing patchy and half showing extensive heart uptake. Those with extensive uptake had significantly higher imaging markers compared to patients with patchy or no uptake.

Across all patients, higher imaging values correlated with poorer heart function, as well as increased blood markers of heart stress.

"Our findings established ⁶⁸Ga-FAPI PET/CT as a clinically valuable tool for quantitative assessment of fibroblast activation in non-ischemic cardiomyopathy, which might enable both early disease detection and long-term monitoring of disease progression," noted Yang. "Future studies should explore its utility across non-ischemic cardiomyopathy subtypes to refine diagnostic and prognostic strategies."