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All Journal Farmaka Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research
Arifudin Achmad
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Biochemistry, Genetics & Molecular Biology Chemistry Health Professions Immunology & microbiology Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Public Health

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Kemajuan Terkini dalam Radiofarmaka sebagai Agen Terapi Kanker Payudara Nur Alifa Agus; Holis Abdul Holik; Arifudin Achmad
Farmaka Vol 20, No 2 (2022): Farmaka (Juli)
Publisher : Fakultas Farmasi, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/farmaka.v20i2.39356

Abstract

ABSTRAKKanker payudara merupakan salah satu kanker paling mematikan bagi wanita dan kanker dengan jumlah kasus terbanyak di Indonesia dengan persentase sebesar 18,6%. Manajemen kanker secara tradisional dilakukan berdasarkan identifikasi lesi tumor melalui tahapan pencitraan diagnostik yang kemudian diikuti dengan kemoterapi hingga pembedahan. Tetapi perawatan seperti ini terdapat adanya kerugian seperti toksisitas yang tidak sesuai target, konsentrasi obat yang rendah pada penyakit, serta adanya penetrasi obat yang terbatas. Hal tersebut menjadikan terapi dengan radiofarmaka dan radionuklida menjadi pilihan terapi yang paling disukai baru-baru ini karena memiliki toksisitas minimal dibandingkan dengan pengobatan kanker lainnya. Artikel ini bertujuan untuk merangkum penelitian-penelitian terkini mengenai radiofarmaka sebagai manajemen terapi untuk kanker payudara dalam lima tahun terakhir. Metode yang digunakan dalam penulisan artikel ini yaitu studi tinjauan pustaka (literature review) pada sumber basis data PubMed dan Google Scholar. Dari hasil tinjauan pustaka diperoleh 19 agen terapi target dengan radiofarmaka yang telah diteliti dan menunjukkan hasil yang potensial sebagai terapi kanker payudaraKata kunci: Kanker payudara, Terapi, Radiofarmaka, Radionuklida
The FAPI-FDG Mismatch: Unmasking an Occult Pancreatic Lesion via Fibroblast Activation Imaging Amidst Negative Glucose Metabolism and Morphological Findings Nur Rohmat Maulana Saepudin; Hendra Budiawan; Arifudin Achmad; Trias Nugrahadi; A Hussein S Kartamihardja
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 4 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i4.1548

Abstract

Background: Fibroblast activation protein inhibitor (FAPI) positron emission tomography (PET) has emerged as a promising modality for imaging the tumor microenvironment, specifically targeting cancer-associated fibroblasts (CAFs). While 18F-FDG targets glucose metabolism, 68Ga-FAPI targets stromal activation. Discrepancies between these modalities can offer unique insights into early pathogenesis. We report a rare case of incidental focal pancreatic uptake on 68Ga-FAPI PET/CT in a patient with prostate cancer, occurring in the absence of metabolic activity on 18F-FDG PET/CT or anatomical abnormalities on contrast-enhanced CT. Case presentation: A 75-year-old male with a history of acinar adenocarcinoma of the prostate (Gleason 7, post-TURP) underwent multimodal staging to evaluate for metastasis. 68Ga-PSMA PET/CT showed intermediate uptake in the prostate but no distant metastasis. Subsequent 68Ga-FAPI-04 PET/CT revealed a striking, intense focal uptake in the pancreatic body. Conversely, follow-up 18F-FDG PET/CT demonstrated physiological background uptake in the pancreas, and abdominal CT showed no pancreatic mass. Laboratory results indicated a slightly elevated CA 19-9 (45.6 U/mL). The findings present a diagnostic dilemma between early stromal-rich malignancy and focal inflammatory processes. Conclusion: This case highlights the FAPI-FDG Mismatch, suggesting that stromal remodeling may precede metabolic reprogramming and morphological changes in pancreatic lesions. 68Ga-FAPI PET/CT demonstrates superior sensitivity for detecting occult stromal activity, necessitating new diagnostic algorithms for incidentalomas in the era of stromal imaging.
The FAPI-FDG Mismatch: Unmasking an Occult Pancreatic Lesion via Fibroblast Activation Imaging Amidst Negative Glucose Metabolism and Morphological Findings Nur Rohmat Maulana Saepudin; Hendra Budiawan; Arifudin Achmad; Trias Nugrahadi; A Hussein S Kartamihardja
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 4 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i4.1548

Abstract

Background: Fibroblast activation protein inhibitor (FAPI) positron emission tomography (PET) has emerged as a promising modality for imaging the tumor microenvironment, specifically targeting cancer-associated fibroblasts (CAFs). While 18F-FDG targets glucose metabolism, 68Ga-FAPI targets stromal activation. Discrepancies between these modalities can offer unique insights into early pathogenesis. We report a rare case of incidental focal pancreatic uptake on 68Ga-FAPI PET/CT in a patient with prostate cancer, occurring in the absence of metabolic activity on 18F-FDG PET/CT or anatomical abnormalities on contrast-enhanced CT. Case presentation: A 75-year-old male with a history of acinar adenocarcinoma of the prostate (Gleason 7, post-TURP) underwent multimodal staging to evaluate for metastasis. 68Ga-PSMA PET/CT showed intermediate uptake in the prostate but no distant metastasis. Subsequent 68Ga-FAPI-04 PET/CT revealed a striking, intense focal uptake in the pancreatic body. Conversely, follow-up 18F-FDG PET/CT demonstrated physiological background uptake in the pancreas, and abdominal CT showed no pancreatic mass. Laboratory results indicated a slightly elevated CA 19-9 (45.6 U/mL). The findings present a diagnostic dilemma between early stromal-rich malignancy and focal inflammatory processes. Conclusion: This case highlights the FAPI-FDG Mismatch, suggesting that stromal remodeling may precede metabolic reprogramming and morphological changes in pancreatic lesions. 68Ga-FAPI PET/CT demonstrates superior sensitivity for detecting occult stromal activity, necessitating new diagnostic algorithms for incidentalomas in the era of stromal imaging.
Co-Authors A Hussein S Kartamihardja Hendra Budiawan HOLIS ABDUL HOLIK Nur Alifa Agus Nur Rohmat Maulana Saepudin Trias Nugrahadi