Hepatic fibrosis develops as a response to chronic liver injury, resulting in the formation of fibrous scars.This process is initiated and driven by collagen-producing activated myofibroblasts which reportedly express high levels of platelet derived growth factor receptor-β (PDGFRβ).We therefore regard PDGFRβ as an anchor for diagnosis and therapy.The Fibrobody SP02SP26-ABD is a biparatopic VHH-construct targeting PDGFRβ.Here, we explore its potential as a theranostic vector for liver fibrosis.Specificity, cross-species binding, and cellular uptake of SP02SP26-ABD was assessed using human, mouse and rat PDGFRβ ectodomains and PDGFRβ-expressing cells.Cellular uptake by PDGFRβ-expressing cells was also evaluated by equipping the Fibrobody with auristatinF and reading out in vitro cytotoxicity.The validity of PDGFRβ as a marker for active fibrosis was confirmed in human liver samples and 3 mouse models of liver fibrosis (DDC, CCl4, CDA-HFD) through immunohistochem. and RT-PCR.After radiolabeling of DFO*-SP02SP26-ABD with 89Zr, its in vivo targeting ability was assessed in healthy mice and mice with liver fibrosis by PET-CT imaging, ex vivo biodistribution and autoradiog.SP02SP26-ABD shows similar nanomolar affinity for human, mouse and rat PDGFRβ.Cellular uptake and hence subnanomolar cytotoxic potency of auristatinF-conjugated SP02SP26-ABD was observed in PDGFRβ-expressing cell lines.Immunohistochem. of mouse and human fibrotic livers confirmed co-localization of PDGFRβ with markers of active fibrosis.In all three liver fibrosis models, PET-CT imaging and biodistribution anal. of [89Zr]Zr-SP02SP26-ABD revealed increased PDGFRβ-specific uptake in fibrotic livers.In the DDC model, liver uptake was 12.15 ± 0.45, 15.07 ± 0.90, 20.23 ± 1.34, and 20.93 ± 4.35%ID/g after 1,2,3 and 4 wk of fibrogenesis, resp., compared to 7.56 ± 0.85%ID/g in healthy mice.Autoradiog. revealed preferential uptake in the fibrotic (PDGFRβ-expressing) periportal areas.The anti-PDGFRβ Fibrobody SP02SP26-ABD shows selective and high-degree targeting of activated myofibroblasts in liver fibrosis, and qualifies as a vector for diagnostic and therapeutic purposes.