Fibroblast activation protein inhibitor (FAPI) PET/CT is a new tool in the diagnostic workup of cancer. With a growing volume of applications, pitfalls and common findings need to be considered for ⁶⁸Ga-FAPI PET/CT image interpretation. The aim of this study was to summarize common findings and report pitfalls in ⁶⁸Ga-FAPI PET/CT. Methods: Ninety-one patients underwent whole-body PET/CT with either FAPI-04 (n = 25) or FAPI-46 (n = 66). Findings were rated in a consensus session of 2 experienced readers. Pitfalls and common findings were defined as focal or localized uptake above the background level and categorized as unspecific or nonmalignant and grouped into degenerative, muscular, scarring/wound-healing, uterine, mammary gland, and head-and-neck findings. The frequency of findings was reported on a per-patient and per-group basis, and SUV_max, SUV_mean, and SUV_peak were measured. Results: Non–tumor-specific uptake was found in 81.3% of patients. The most frequent finding was uptake in degenerative lesions (51.6%), with a mean SUV_max of 7.7 ± 2.9, and head-and-neck findings (45.1%). Except for the salivary glands, the uptake values did not differ between 10 and 60 min after injection in most findings. Uterine uptake was found in most women (66.7%), with a mean SUV_max of 12.2 ± 7.3, and uptake correlated negatively with age (SUV_max, r = –0.6, P < 0.01; SUV_peak, r = –0.57, P < 0.01; SUV_mean, r = –0.58, P < 0.01). Conclusion: Pitfalls include non–tumor-specific ⁶⁸Ga-FAPI uptake in degenerative lesions, muscle, the head and neck, scarring, the mammary glands, or the uterus. Here, we summarize the findings to help readers avoid common mistakes at centers introducing ⁶⁸Ga-FAPI PET/CT.

成纤维细胞活化蛋白抑制剂 (FAPI) PET/CT 是癌症诊断检查的新工具。随着应用量的增加，需要考虑⁶⁸ Ga-FAPI PET/CT 图像解释的陷阱和常见发现。本研究的目的是总结⁶⁸ Ga-FAPI PET/CT 的常见发现并报告缺陷。方法： 91 名患者接受了 FAPI-04（n = 25）或 FAPI-46（n= 66). 在 2 位经验丰富的读者的共识会议上对调查结果进行了评级。缺陷和常见发现被定义为高于背景水平的局灶性或局部摄取，并被归类为非特异性或非恶性，并分为退行性、肌肉、疤痕/伤口愈合、子宫、乳腺和头颈部发现。结果的频率按每个患者和每个组报告，并测量 SUV_最大值、SUV_平均值和 SUV_峰值。结果：在 81.3% 的患者中发现了非肿瘤特异性摄取。最常见的发现是在退行性病变中摄取 (51.6%)，平均 SUV_最大值7.7 ± 2.9，以及头颈部检查结果 (45.1%)。除唾液腺外，在大多数发现中，注射后 10 至 60 分钟的摄取值没有差异。大多数女性 (66.7%) 发现子宫吸收，平均 SUV_最大值为 12.2 ± 7.3，吸收与年龄呈负相关（SUV_最大值，r = –0.6，P < 0.01；SUV_峰值，r = –0.57，P < 0.01；SUV_平均值，r = –0.58，P < 0.01)。结论：陷阱包括非肿瘤特异性⁶⁸Ga-FAPI 在退行性病变、肌肉、头部和颈部、疤痕、乳腺或子宫中的吸收。在这里，我们总结了这些发现，以帮助读者避免在引入⁶⁸ Ga-FAPI PET/CT 的中心出现的常见错误。