JRI (Jurnal Radiografer Indonesia)

Penerapan Modifikasi Faktor Eksposi Aturan 10 kV Terhadap Kualitas Citra Radiografi Thorax Modalitas CR vs DR

2024-06-06T08:30:30+00:00

Background: The use of Computed Radiography (CR) and Digital Radiography (DR) makes Radiographers pay less attention to the selection of exposure factors, resulting in overexposed and underexposed. One technique for optimizing and maintaining image quality in CR and DR is modification of the exposure factor of the 10kV rule. This study aims to compare image quality (histogram, noise, signal to noise ratio (SNR), and exposure index (EI)) in CR and DR by applying the modified exposure factor rule of 10 kV to chest radiographs.

Methods: Quantitative research with an experimental approach using the Perlove PLX 101 C mobile X-ray aircraft, thorax phantom, CR Prima T2 and AeroDR 3 1417HL DR detector. Data was generated by exposing the phantom using an anteroposterior (AP) chest radiography examination technique. Exposure was carried out 3 times for CR and DR with 60kVp 10mAs, 50 kVp 20 mAs and 70kVp 5mAs. Noise measurement through region of interest (ROI) in the background area. The SNR value with ROI is a comparison between the mean value of the pulmonary and costal anatomy with background noise. CR and DR image histograms were obtained using the Image-J application. Exposure index and sensitivity values by looking at the CR monitor. Then the data is processed and analyzed statistically.

Results: Modification of the 10 kV regulatory exposure factor produces the highest noise image at 70kVp 5mAs, namely 7.82 in CR and 10.6 and there are differences between other exposure factors with a p-value <0.001. The pulmonary and costal SNR values in DR were higher than the SNR in CR for all exposure factors and there was a difference with a p-value <0.001. The histograms on CR and DR are flat and homogeneous. The highest CR exposure index value was at 60kVp 10mAs, namely 2760 and the lowest was at 70kVp 5mAs, namely 1997 with sensitivity classified as overexposure for all exposure factors because it was below 75/mR.

Conclusions: Application of the modified exposure factor rule of 10kV to AP chest radiographs causes differences in the quality of DR and CR images. The lowest noise and highest SNR are found in DR images with an exposure factor of 50kVp 20mAs, but the lowest exposure index is at 70kVp 5mAs

Analisis Nilai Conformity Index (CI) Dan Homogeneity Index (HI) Hasil Planning Penyinaran Pasien Kanker Paru

2024-06-06T08:29:32+00:00

Background: The objective of radiotherapy is to give a maximum dose which very closely conforms to the target volume homogeneously, while minimizing the dose to the surrounding normal tissue and Organs at Risk (OAR). For that reason, Conformity Index (CI) and Homogeneity Index (HI) are two important tools in evaluating treatment planning in radiotherapy, because it can help evaluate the conformity level as well dose distribution uniformity in the target volume. One of the clinical competences which must be owned by a Radiotherapist is that he/she must be able to evaluate the irradiation treatment planningresults. In relation to which, this research aims to describe radiotherapy irradiation procedure of Lungs Cancer as well as to identify and analyze CI and HI values of lungs cancer planning results in Radiotherapy Installation of Siloam MRCCC Hospital Semanggi.

Methods: As for the research design used is observational research by applying a qualitative descriptive method undertaken at Radiotherapy Installation of Siloam MRCCC Hospital Semanggi by using secondary data as many as 20 lungs cancer patients starting from January up to June 2023.

Results: This research suggests that out of 20 patient samples of lungs cancer planning results, found that there are 4 samples of CI value classified into the criteria of a little bit in deviation according to RTOG. This matter is caused by an adjacent tumor location with OAR, in the effort to maintain that OAR is appropriate with the desired dose contraint, the target area of tumor may be underdosed, consequently the result of CI is less conformal. For HI values, all 20 samples have produced high dose distribution homogeneity.

Conclusions: Out of 20 patient samples of lungs cancer planning results, found that the range mark of CI is 0.965–1.223 and the range of HI value is 0.041–0.133. There are 4 samples of CI value classified into the criteria of a little bit in deviation according to RTOG. For HI values, all 20 samples have produced high dose distribution homogeneity.

Analisis Perhitungan Nilai Biodistribusi Tc-99m Perteknetat Pada Pasien Hipertiroid

2024-06-06T08:27:07+00:00

Background : The distribution value of the Tc-99m radiopharmaceutical in 02 hyperthyroid patients at a Jakarta Hospital was calculated to determine the absorption dose value of the radiopharmaceutical in the thyroid organ. Thyroid scan is a type of examination carried out on patients using a SPECT aircraft equipped with a dual gamma camera detector. The radiopharmaceutical Tc-99m perteknetate is injected into the patient's body via an intravenous line at 3-5 mCi with an imaging time of 15 minutes. Biodistribution determination analysis can be calculated using the ROI technique.

Method : This study is quantitative by collecting data from 10 patients with clinical hyperthyroidism which aims to determine and determine the biodistribution of radiopharmaceutical activity injected into the patient's body.

Result : The results showed that the average biodistribution value of Tc-99m radiopharmaceuticals in the right lobe of the thyroid was greater at 24.59 MBq than the left lobe of the thyroid at 22.96 MBq and the total thyroid biodistribution value was 30.77 MBq. The largest biodistribution was owned by patient number 6 (SR) with a thyroid size of 137.83 MBq, right lobe 68.88 MBq, and left lobe 65.95 MBq while the lowest biodistribution value was in patient number 9 (TBD) with a thyroid size of 8.37 MBq, right lobe 5.23 MBq, left lobe 2.46 MBq.

Conclusion : The average biodistribution of the right lobe is greater than the left lobe in hyperthyroid patients. Radiopharmaceuticals that flow with blood flow cause asymmetrical enlargement of the right lobe so that the distribution of Tc-99m is more in the right lobe.

Analisis Software Semi Otomatis dan Artificial Intelligence Dalam Menentukan Letak Kalsifikasi dan Nilai Agatstone Score

2024-06-06T08:28:20+00:00

Background: Medically, an important indicator from cardiovascular disease is the enhancement of calcification. For that reason, the assessment of Calcium Score and Artificial Intelligence have the same potential to help or even to replace human role, hence, it can reduce clinical work burden and improving an efficiency. This research aims to analyze a difference between Artificial Intelligence and semi-automatic methods in determining the calcification location and Agatstone Score value undertaken at Radiology and Nuclear Cardiology Installation of Harapan Kita Heart and Blood Vessel Hospital, West Jakarta.

Methods: Research design used is descriptive quantitative method, this research was executed in Radiology and Nuclear Cardiology Installation starting from October up to November 2023 with the total number of samples as many as 50 secondary data

Results: Result of this research shows that there is no significant difference between Artificial Intelligence-based software and semi-automatic methods in determining the mark of Agatstone Score and location calcification

Conclusions: Based on the results of the research and discussion analyzing semi-automatic software and Artificial Intelligence in determining the location of classification and Agatstone Score values, it can be concluded that the superiority of Artificial Intelligence-based post-processing software in determining the location of classification and Agatstone Score values lies in the fact that this software provides ease in rapidly and accurately reconstructing the assessment of classification locations, especially in cases of minimal lesions in blood vessels. It is faster and simpler in determining Agatstone Score values compared to semi-automatic methods because the software automatically works to determine the total Agatstone Score value.

Analisis Penggunaan Semac Dalam Mereduksi Artefak Pada MRI Dengan Metal Prothesis

2024-06-06T08:25:58+00:00

Background: The need to display lesions close to the area where orthopaedic implants are placed requires the use of metal artefact reduction techniques with optimal examination time. The presence of metal implants in MRI can cause substantial image artefacts, including signal loss, fat suppression failure, geometric distortion, and hyperintense signal pile up artefacts. This leads to large resonant frequency changes and failure of many MRI mechanisms. SEMAC or Slice Encoding Metal Artefact Correction is a sequence or algorithm to reduce metal artefacts caused by implant magnetic susceptibility but the acquisition time is quite long The need to display lesions close to the area where orthopaedic implants are placed requires the use of metal artefact reduction techniques with optimal examination time. The presence of metal implants in MRI can cause substantial image artefacts, including signal loss, fat suppression failure, geometric distortion, and hyperintense signal pile up artefacts. This leads to large resonant frequency changes and failure of many MRI mechanisms. SEMAC or Slice Encoding Metal Artefact Correction is a sequence or algorithm to reduce metal artefacts caused by implant magnetic susceptibility but the acquisition time is quite long..Methods: This research applies an analysis qualitative descriptive method using a phantom approach with a metal prosthesis type SS 316L executed at Fatmawati Central General Hospital in October 2023. As for the population used, it is phantom with a sample of 18 patents. Data collection methods are namely observation and interviews. The research instruments were observation sheets and interview guidelines.Results:The analysis results show that signal loss artefacts are still quite extensive and interfere with the image, signal loss can be reduced by increasing the SES value. Signal pile up artefacts are few and do not disturb the image. The implant edge structure cannot be visualised close to the original shape because the artefacts are quite extensive and distorted in the implant area.Conclusions:The SEMAC sequence with the selection of SES values of 6, 10 or 15 is one way to reduce metal artefacts and can be combined with grappa to shorten the acquisition time.

Teknik Radioterapi 3DCRT pada Kasus Kanker Lidah Instalasi Radioterapi Rumah Sakit Pusat Kanker Nasional

2024-06-06T08:21:59+00:00

Background: One of the radiotherapy techniques is 3 Dimensional Conformal Radioteraphy (3DCRT). In the radiotherapy installation at the Kanker Dharmais Hospital, some tongue cancer use the 3 Dimensional Conformal Radiotherapy (3DCRT) technique. The purpose of this study was to analyze the 3 Dimensional Conformal Radiotherapy (3DCRT) technique in the radiotherapy installation of the Kanker Dharmais Hospital.

Methods: This type of research is descriptive qualitative with one primary sample on tongue cancer using CT Simulator GE Optima and Linac CX-SN4556, Varian, energy 6MV with the 3 Dimensional Conformal Radiotherapy (3DCRT) Technique. Use The way of collecting data is by observasing, interviewing, and documenting. This research was conducted at the radiotherapy installation at the Kanker Dharmais Hospital.

Results: The 3 Dimensional Conformal Radiotherapy (3DCRT) technique procedure in the radiotherapy installation of the Kanker Dharmais Hospital which was carried out including the patient preparation procedure, the CT Simulation process in the CT Simulator, the radiation planning process in the Treatment Planning System (TPS) room, the radiation verification process using Electronic Portal Imaging Device (EPID) and finally the irradiation process with Linac.

Conclusions: The reasearch summary can provide information, insight and become reference material for readers, especially students, about how 3 dimentional conformal radiotherapy (3dcrt) radiotherapy techniques in case of tongue cancer in radiotherapy installations of the national cancer center hospital

Rancang Bangun Viewing Box Deteksi Film Otomatis dan Pengaturan Tingkat Pencahayaan

2024-06-06T08:23:53+00:00

Latar belakang: Salah satu faktor yang mempengaruhi informasi yang diberikan dari hasil radiografi adalah gambaran objek yang sesuai kriteria gambaran. agar mempermudah radiolog dalam membuat hasil expertise maka digunakan Viewing Box .

Metode: Penelitian ini menggunakan metode deskriptif dengan pendekatan rancang bangun alat Viewing Box . Pembacaan foto rontgen dilakukan dengan menggunakan Viewing Box . Pengujian Viewing Box melibatkan 20 responden yang terdiri dari 2 radiolog dan 18 Radiografer untuk menjawab pertanyaan pada kuesioner.

Hasil: Berdasarkan hasil rata-rata kuesioner yang dinilai oleh dokter Radiolog dan Radiografer dengan melihat dan mecoban Viewing Box tersebut, maka di ketahui nilai rata-rata keseluruhan sebesar 3,86.

Jika dilihat dari bobot nilai dari kuesioner mendapat nilai sangat baik

Kesimpulan: Viewing Box ini dapat digunakan secara optimal sebagai alat bantu dalam membaca hasil foto rontgen.

Upaya Pelaksanaan Keselamatan Kerja terhadap Bahaya Radiasi pada Pekerja Radiologi

2024-06-06T08:22:46+00:00

Background: The development and use of radioactive substances or radiation sources in Indonesia is increasing in terms of quantity and equipment. besides being able to provide good results, their utilization will cause hazards. Therefore the work safety factor needs to be considered and maintained.

Research Objective: This research to know how work safety implementation against radiation hazards for Radiographer .

Method: This research is a qualitative descriptive design method which to know work safety implementation against radiation hazards for Radiographer. The sample in this research were 16 radiographers at Ulin Banjarmasin Hospital.

Results: Radiation dose average score is 16 and average percentage value 100% with answers carried out monitoring, radiation protection equipment results of an average score is 16 with an average percentage 100% of respondents answered to function, radiation protection officers obtained an average percentage average 81.25% of respondents answered mastered with an average score is 13. Respondents who answered less mastered got a percentage 18.75% with an average score is 3, radiation workers in getting an average percentage of overall 77.5% answered implemented with an average score is 12.4 respondents answering were carried out. Respondents who answered were not implemented getting a percentage 22.5% with an average score is 3.6.

Conclusion: Radiographers at Ulin Hospital Banjarmasin have knowing, understanding and implementing all provisions of radiation work safety, implementing work instructions that prepared by PPR correctly.

Bronkiektasis dengan Emfisema Bulosa pada Pasien Post Tuberkulosis Paru: Sebuah Studi Kasus

2024-06-06T08:24:53+00:00

Latar Belakang: Bronkiektasis merupakan penyakit paru-paru kronis yang ditandai dengan dilatasi bronkus irreversible yang persisten, disertai proses inflamasi pada dinding bronkus. Sebelumnya prevalensi bronkiektasis tidak banyak diketahui namun statistic global menunjukkan bahwa kejadian bronkiektasis telah meningkat selama beberapa tahun terakhir dan bisa mengenai semua kelompok usia. Di Indonesia belum ada laporan angka pasti mengenai penyakit ini, namun cukup sering ditemukan di klinik atau rumah sakit.

Tujuan: Untuk melaporkan kasus bronkiektasis dengan emfisema bulosa pada pasien post tubekculosis paru, wanita berusia 63 tahun di Rumah Sakit Bethesda, Yogyakarta.

Deskripsi Kasus: Wanita berusia 63 tahun datang ke Poli Radiologi Rumah Sakit Bethesda Yogyakarta dengan keluhan kontrol pengobatan post TB Paru, disertai batuk minimal dan terkadang mengalami sesak nafas. Pasien terdiagnosis TB pada 18 Mei 2022 dan telah melakukan pengobatan TB selama 9 bulan, hingga terdiagnosis sembuh oleh dokter pada 27 Maret 2023. Pasien memiliki riwayat penyakit maag dan anoreksia, serta alergi ethambutol. Kondisi pasien saat datang kontrol ke rumah sakit yaitu compos mentis dengan GCS total 15 (E4V5M6), tampak lemas, tekanan darah 120/70 mmHg, frekuensi nadi 84 kali/menit, frekuensi nafas 22 kali/menit, SpO2 98% dan suhu 36,4^oC. Pada pemeriksaan fisik paru didapatkan suara dasar vesikuler +/+, ronkhi -/-, dan wheezing +/-. Pemeriksaan HRCT thorax menunjukkan tanda volume loss di paru dekstra dengan bronkiektasis dengan garis fibrotic disekelilingnya dan proses awal bronkiektasis di paru sinistra lobus inferior segmen anterior, menyokong post infeksi TB.

Kesimpulan: Bronkiektasis ditandai oleh dilatasi bronkus yang irreversible dan persisten, disertai proses inflamasi pada dinding lumen bronkus dan parenkim paru. Etiologi paling sering dari bronkiektasis ialah post infeksi paru, seperti tuberculosis.Pada bronkiektasis post TB juga dapat memberikan gambaran multiple bula pada paru (emfisema bulosa). Diagnosis ditegakkan berdasarkan kondisi klinis dan pencitraan radiologi. Sangat diperlukan penanganan yang adekuat terhadap kasus TB Paru dan modifikasi gaya hidup yang tepat, sehingga dapat meminimalisir kerusakan paru yang mungkin ditimbulkan pasca infeksi TB.

Profil Dosis Sekunder Ct Scan Sinus Paranasal Dengan Aplikasi Software Organ Dose Modulation (ODM)

2024-06-06T08:21:21+00:00

Background: A radiological examination that can be used to evaluate SPN and facial bones is CT SPN. CT SPN increases the potential risk of radiation effects, especially on sensitive organs (thyroid and mammae). CT SPN exposure does not only affect the main organs but also the surrounding organs (secondary doses). The secondary dose also increases the risk of stochastic effects. Unfortunately, secondary doses are rarely measured. So, there is a need for safety and radiation protection like using Organ Dose Modulation (ODM) software. The purpose of this study was To determine the secondary dose in CT SPN using ODM software.

Methods: This research is quantitative research with an experimental study approach carried out in March–May 2023 at the Radiology Installation of Indriati Solo Baru Hospital. This research was carried out by scanning the phantom with standard CT SPN protocol and adding ODM software, then measuring the dose using TLD BARC which was placed on the thyroid and mammae area. The results of the absorbed dose in thyroid and mammae were analyzed descriptively and analytically.

Result: The mean absorbed dose value in the thyroid gland area without ODM software was 9.44 mSv and with ODM software was 5.12 mSv. In the breast area without ODM software, the mean absorbed dose value was 0.85 mSv, while using ODM software was 0.59 mSv. The decreased absorbed dose using ODM software in the thyroid is 44,57% and in the breast is 29,85%.

Conclusion: Using ODM software in CT SPN can reduce the secondary dose (thyroid and breast areas)