自从纤维母细胞活化蛋白-靶向放射性药物的发展以来，发现68Ga-纤维母细胞活化蛋白抑制剂（FAPI）PET/CT适用于检测多种肿瘤的原发和转移病灶。然而，目前关于该类探针临床影响的可靠数据仍然缺乏。为了弥补这一空白，本研究旨在通过检查一大批不同肿瘤患者，分析68Ga-FAPI PET/CT的临床影响。方法：共纳入226名患者（男性137名，女性89名）进行回顾性分析。胰腺癌和头颈癌是该队列中最常见的肿瘤类型。首先使用金标准成像确定TNM分期和肿瘤学管理，并将这些结果与68Ga-FAPI PET/CT进行比较。变化被分为主要变化和次要变化。结果：对于所有患者的42％，TNM分期由68Ga-FAPI PET/CT结果改变。其中大部分变化导致升级分期。在226名患者中，有117名患者的临床管理发生变化。尽管只有12％的患者出现了重大管理变化，但在准确规划放射治疗方面有明显改进。总的来说，68Ga-FAPI PET/CT成像在肺癌、胰腺癌和头颈肿瘤患者中的临床影响最大。结论：68Ga-FAPI PET/CT是一种有前景的成像探针，对TNM分期和临床管理有重要影响。68Ga-FAPI PET/CT有望成为至关重要的新技术，对于癌症分期通常采用的增强CT和增强MRI等传统放射学成像方法进行改进。© 2023年核医学与分子影像学会发布。

Since the development of fibroblast activation protein-targeted radiopharmaceuticals, 68Ga-fibroblast activation protein inhibitor (FAPI) PET/CT has been found to be suitable for detecting primary and metastatic lesions in many types of tumors. However, there is currently a lack of reliable data regarding the clinical impact of this family of probes. To address this gap, the present study aimed to analyze the clinical impact of 68Ga-FAPI PET/CT by examining a large cohort of patients with various tumors. Methods: In total, 226 patients (137 male and 89 female) were included in this retrospective analysis. Pancreatic cancer and head and neck cancers were the most common tumor types in this cohort. TNM stage and oncologic management were initially determined with gold standard imaging, and these results were compared with 68Ga-FAPI PET/CT. Changes were classified as major and minor. Results: For 42% of all patients, TNM stage was changed by 68Ga-FAPI PET/CT results. Most of these changes resulted in upstaging. A change in clinical management occurred in 117 of 226 patients. Although a major change in management occurred in only 12% of patients, there was a significant improvement in the ability to accurately plan radiation therapy. In general, the highest clinical impact of 68Ga-FAPI PET/CT imaging was found in patients with lung cancer, pancreatic cancer, and head and neck tumors. Conclusion: 68Ga-FAPI PET/CT is a promising imaging probe that has a significant impact on TNM stage and clinical management. 68Ga-FAPI PET/CT promises to be a crucial new technology that will improve on conventional radiologic imaging methods such as contrast-enhanced CT and contrast-enhanced MRI typically acquired for cancer staging.© 2023 by the Society of Nuclear Medicine and Molecular Imaging.