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Secondary aim was to evaluate whether OA disease severity is positively correlated with increased tracer uptake and to evaluate reliability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>\n                      In a retrospective study design, patients who had undergone\n                      <jats:sup>68<\/jats:sup>\n                      \u00a0Ga-FAPI PET-CT for a spectrum of clinical reasons were included. Whole-body CT was assessed for OA using the OsteoArthritis Computed Tomography\u2010Score in multiple joints and the spine. Maximum standard uptake value (SUV\n                      <jats:sub>max<\/jats:sub>\n                      ) was determined correspondingly. Logistic regression and correlation analyses were used to describe associations between structural OA and\n                      <jats:sup>68<\/jats:sup>\n                      \u00a0Ga-FAPI PET activity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty-four patients were included. Presence of OA in the acromioclavicular joints (ACJ) was associated with odds of SUV\n                      <jats:sub>max<\/jats:sub>\n                      being in the highest tertile. Increased odds were seen for one location of the cervical spine (OR 5.7, 95% confidence interval [1.6, 20.4]) and both locations of the lumbar spine (OR 8.3, 95% confidence interval [1.5, 46.6]; 5.0, 95% confidence interval [1.3, 18.7]). Moderate correlations were observed for OA severity and\n                      <jats:sup>68<\/jats:sup>\n                      \u00a0Ga-FAPI PET uptake for most joints and spine. Reliability for OA scoring (overall percent agreement) ranged from 40 to 100% (intra-reader) and from 66.3 to 100% (inter-reader). Mean intraclass correlation coefficients for SUV\n                      <jats:sub>max<\/jats:sub>\n                      were 0.76 and 0.82, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Presence of OA was associated with increased SUV\n                      <jats:sub>max<\/jats:sub>\n                      uptake for the ACJ and the cervical and lumbar spine. In this feasibility study, CT-based OA scoring and\n                      <jats:sup>68<\/jats:sup>\n                      \u00a0Ga-FAPI PET SUV\n                      <jats:sub>max<\/jats:sub>\n                      determinations could be achieved with good reliability.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00256-026-05354-5","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T07:17:59Z","timestamp":1788160679000},"page":"3297-3313","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Osteoarthritis and fibroblast activation: an imaging study assessing feasibility and reliability of whole-body 68\u00a0Ga-FAPI PET-CT for structural osteoarthritis evaluation"],"prefix":"10.1007","volume":"55","author":[{"given":"Anna Katharina","family":"Roemer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Heiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Schmidkonz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie E.","family":"Collins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Gabriella","family":"Raimondo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Beck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Guermazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"B\u00e4uerle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Schett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Uder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torsten","family":"Kuwert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Ramming","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank W.","family":"Roemer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina Mihaela","family":"Ramming","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armin","family":"Atzinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"issue":"9783","key":"5354_CR1","doi-asserted-by":"publisher","first-page":"2115","DOI":"10.1016\/S0140-6736(11)60243-2","volume":"377","author":"JW Bijlsma","year":"2011","unstructured":"Bijlsma JW, Berenbaum F, Lafeber FP. 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Semin Nucl Med. 2024;54(3):345\u201355. https:\/\/doi.org\/10.1053\/j.semnuclmed.2023.11.003.","journal-title":"Semin Nucl Med"}],"container-title":["Skeletal Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00256-026-05354-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00256-026-05354-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00256-026-05354-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T20:47:34Z","timestamp":1792010854000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00256-026-05354-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":35,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2026,12]]}},"alternative-id":["5354"],"URL":"https:\/\/doi.org\/10.1007\/s00256-026-05354-5","relation":{},"ISSN":["0364-2348","1432-2161"],"issn-type":[{"value":"0364-2348","type":"print"},{"value":"1432-2161","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,31]]},"assertion":[{"value":"23 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 August 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 August 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 August 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Patients were asked if their data could be used for retrospective research in anonymized fashion, and informed consent was obtained. The study was approved by the Ethics Committee of the Friedrich-Alexander-Universit\u00e4t (FAU) Erlangen-N\u00fcrnberg (#23\u2013359-Bp). All procedures performed were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"F.W.R. is a shareholder of Boston Imaging Core Lab (BICL), LLC. He is Editor-in-Chief of\n                      Osteoarthritis Imaging\n                      journal.J.E.C. is a consultant to Boston Imaging Core Lab (BICL), LLC.A.G. has received consultancies, speaking fees, and\/or honoraria from Galapagos, Pfizer\/Lilly, Roche, AstraZeneca, Merck Serono, and TissueGene, and is President and a shareholder of Boston Imaging Core Lab (BICL), LLC, a company providing image assessment services.A.R. has received grants\/research support from Boehringer-Ingelheim, Moonlake, Novartis, and Pfizer. He worked as a paid consultant for AbbVie, Alfasigma, Amgen, Boehringer-Ingelheim, Janssen, Moonlake, Novartis, and UCB. He has been paid as a speaker for AbbVie, Alfasigma, Amgen, Boehringer-Ingelheim, Bristol Myers Squibb, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. He is a shareholder of TissueImmune Therapeutics GmbH.The other authors declare no competing interests.","order":2,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"No generative AI was used in data interpretation or writing of the manuscript.","order":3,"name":"Ethics","label":"Declaration of generative AI in scientific writing","group":{"name":"EthicsHeading","label":"Declarations"}}]}}