JRI (Jurnal Radiografer Indonesia)

Efektivitas Penambahan Proyeksi Hiperfleksi dan Hiperekstensi Pemeriksaan Lumbal sebagai Upaya Penegakkan diagnosa Low Back Pain

Dyah Ayu Puspitaningtyas — 2025-05-31

Background: Lumbar examination at KRMT Wongsonegoro Hospital Semarang in case of low back pain caused by spondylolisthesis not only use AP projection routine and lateral but also adding hyperflexion and hyperextension projections. Research aims to understand effectiveness in addition of hiperfleksi projection and hyperextension at KRMT Wongsonegoro Hospital Semarang.

Methods: This type of research is qualitative descriptive approached by case study. Data collection by observation and interviews conducted to some respondents consisting of radiographers, radiologist and orthopedist.

Results: Showed that Low back pain caused by spondylolisthesis, radiographic evaluation should consist of lateral hyperflexion and hyperextension radiographs as these projections help determine the displacement instability of the bone. Flexion-extension radiographs in standing position usually used to measure the degree of intervertebral instability, standing position of flexion-extension radiography is also often used in conjunction with clinical signs and symptoms to decide between management conservative and surgical. The projection also helps the radiologist to determine degree of movement of the bones so that any changes in displacement of position can be clearly seen.

Conclusions: Adding hyperflexion and hyperextension projections in this case can confirm the diagnosis and provide additional information as these projections are made for the purpose of studying the motion function of the spine and can determine the degree of angulation, displacement or narrowing of a vertebra.

Analisis Informasi Citra Anatomi Antara Sekuen 3D CISS dan 3D SPACE Pada MRI Brain Potongan Axial Dengan Klinis Trigeminal Neuralgia

Fatimah — 2025-05-31

Background: MRI examination of the brain using 3D CISS and 3D SPACE sequences is often used for cranial nerve-related diagnosis. MRI can show images of cranial nerves, subtentorial masses, and neurovascular compression. In this study, the Radiology Installation of RSPON Prof. Dr. Mahar Mardjono Jakarta used 3D SPACE sequences, but there were differences in the selection of sequences used in several other hospitals. The purpose of this study is to determine the difference in anatomical image information and the most optimal sequence in displaying image information between 3D CISS and 3D SPACE sequences with trigeminal neuralgia.

Methods: This study was conducted on 10 patients with trigeminal neuralgia in the range of 40 - 75 years. The image assessment was carried out by three radiology specialists by assessing the clarity of CN V, root entry zone, Meckel's cave, SCA, and AICA. Anatomical information which was assessed with a score range of 1-3. The resulting data was ordinal data. Data analysis was carried out using the Wilcoxon statistical test.

Results: The results of this study showed that there was a difference in anatomical image information between 3D CISS and 3D SPACE sequences which showed a p-value of 0.00 (p < 0.05). This study also shows that there was a difference in information from each anatomy assessed, so that the more optimal sequence in providing an overview of anatomical information on MRI examination of axial brain with trigeminal neuralgia is the 3D SPACE sequence with a mean rank value 25.00.

Conclusions: There was a difference in anatomical image information between 3D CISS and 3D SPACE. 3D SPACE can provide a more optimal image of anatomical information and sharper image results when compared to 3D CISS and a shorter scanning time.

Prosedur Pemeriksaan CT Scan Kepala Kontras Pada Kasus Space Occupying Lesion (SOL) di Instalasi Radiologi RSUP Dr. M. Djamil Padang

Rais Sahidin — 2025-05-31

Background: Space Occupying Lesion (SOL) is a large group that describes the presence of lesions in the intracranial space. Intracranial lesions can be bleeding, abscesses, or intracranial tumours. The procedure of contrast head CT scan examination in the case of Space Occupying Lesion (SOL) at Radiology Department of Dr. M. Djamil Hospital Padang is that the patient fasts before the examination and checks Ureum and Creatinine. During the examination, 50 ml of contrast media was used and the scan delay was 30 seconds. The purpose of this study was to explain the procedures and reasons for using 50 ml of contrast media and a 30 second scan delay.

Methods: This type of research is qualitative research with a case study approach. Data collection was carried out by observation, interviews with respondents, namely sending doctors, radiology specialists, radiographers, patients or families and documentation. The data obtained was then analysed using an interactive data model, namely data collection, data reduction, data presentation and conclusion drawing.

Results: The results of the study showed that the procedure for contrast head CT scan examination in Space Occupying Lesion (SOL) cases at Radiology Installation of Dr. M. Djamil Hospital Padang. Patients fasting 6 hours, check ureum and creatinine, sign informed consent, do skin test. At the time of the examination there were two scans, namely pre and post contrast using 50 ml contrast media, 30 ml NaCl and a 30 second scan delay injected using an injector machine.

Conclusions: The use of contrast media as much as 50 ml and a scan delay of 30 seconds can already show abnormalities and characteristics of Space Occupying Lesion (SOL) ranging from structure, shape, nature and vascularity.

Peran APR-246 dalam Mengaktivasi P53 yang Berkaitan dengan Sensitivitas terhadap Respon Radioterapi: Studi Literatur

Annisa Fauzia — 2025-05-31

Background: Cancer is a significant challenge to life expectancy globally. The main treatment modalities for cancer include chemotherapy, surgery, and radiotherapy. Radiotherapy targets only the affected body area, treatment directly targets cancer cells. Despite significant advancements in understanding the molecular mechanisms of carcinogenesis and the development of modern radiotherapy techniques, treatment effectiveness can vary due to factors like radioresistance. One of the key processes responsible for this radioresistance is the effectiveness of DNA damage repair following radiation exposure.

Methods: This study is a narrative review based on articles from PubMed, ClinicalKey, and ScienceDirect, covering the period from 2014 to 2024. To support the theoretical framework, earlier publications before 2014 were also reviewed.

Results: APR-246 (PRIMA-1MET) is a compound capable of restoring the wild-type conformation of p53 and its anti-tumor transcriptional activity by covalently binding to the DNA-binding domain of mutant p53. APR-246 functions as a radiosensitizer by inducing apoptosis and is known for activating and stabilizing the p53 protein.

Conclusion: The induction of apoptosis by the compound APR-246 through p53 activity can trigger a cellular response to radiation-induced stress, thereby facilitating the elimination of genetically damaged cancer cells and ultimately enhancing the response to radiotherapy.

Perbandingan Metode Clipbox dan Mask Pada Teknik Volumetric Modulated Arc Therapy Untuk Verifikasi Pada Kasus Kanker Nasofaring

Nona Zesifa Asia Zaen — 2025-05-31

Background : In 3D radiotherapy using the VMAT technique, verification is crucial to ensure precise patient positioning and target volume alignment, especially in nasopharyngeal cancer cases surrounded by many organs at risk. This study aims to compare the accuracy of two image matching methods clipbox and mask used in Cone Beam Computed Tomography (CBCT) verification during irradiation.

Method : This quantitative, quasi experimental study analyzed irradiation verification data from 31 nasopharyngeal cancer patients during their fourth treatment. The verification process used CBCT with both clipbox and mask methods, measuring shift values on the X, Y, and Z axes. Data were analyzed using the Shapiro Wilk test for normality, followed by the Wilcoxon and Mean Rank tests for comparison.

Results : The mask method was more sensitive in detecting positional shifts on the Y and Z axes. However, the clipbox method showed better overall precision, with a higher Mean Rank score (44.96 vs. 42.93) and smaller standard deviations, indicating more consistent results. Both methods detected minimal average shifts of approximately 0.1 cm, reflecting high verification accuracy.

Conclusion : While the mask method is more accurate in detecting shifts on certain axes, the clipbox method provides greater overall precision and consistency across all axes. Therefore, the clipbox method is considered more suitable for irradiation verification in VMAT based nasopharyngeal cancer treatment.

Efektifitas Cincau Hijau (Cyclea Barbata Miers) Sebagai Pengganti Gel USG

Redha Okta Silfina — 2025-05-31

Background: An ultrasound device must use a conducting medium that will produce the desired image. The most commonly used delivery medium is water-soluble gel. Ultrasound gel made from carbomer 940. Carbomer 940 is a synthetic polymer (non-biodegradable) in which the components cannot decompose and cannot be broken down by microorganisms. Making ultrasound gel made from plants is the main alternative, one of which is made from Cyclea Barbata Miers, also known as green grass jelly leaves. Aim of this study is made an alternative and eco-friendly ultrasound gel for patient.

Methods: This research method made from natural ingredients, namely grass jelly, then directly using an ultrasound transducer and compared it with ultrasound gel made from carbommer 940.

Results: Testing alternative gels using carbomer 940 gel as a comparison in kidney organs, got almost the same results. But, contrast from grass jelly gel was not that good because the gel still rough compare with carbomer 940 based gel got enough contrast and clear image.

Conclusions: Alternative gel of grass jelly for kidney ultrasound was not good because the gel was still coarse compared to carbomer 940. But, grass jelly gel can be an alternative to ultrasound gel, especially from natural ingredients.

Deteksi Kelainan Fibroadenoma Mammae (FAM) melalui Pemeriksaan Ultrasonografi dan Hubungannya dengan Riwayat Penggunaan Kontrasepsi Hormonal di Kalangan Wanita Indonesia

Puspa Pamella Suci — 2025-05-31

Background: Fibroadenoma of the breast (FAM) is the most common benign tumor found in young women, characterized by abnormal proliferation of fibrous and glandular tissue. Ultrasonografi (USG) is widely used as a non-invasive diagnostic tool due to its ability to accurately assess the shape, size, and internal structure of tumors. Hormonal contraceptive use has been investigated as a potential risk factor in the development of FAM.

Methods: This study used a cross-sectional design to examine the relationship between hormonal contraceptive use and FAM incidence in Indonesian women. Data were collected from several health centers equipped with USG facilities, involving women from diverse age and socioeconomic backgrounds. A total of 500 subjects were analyzed, divided into groups based on contraceptive use history.

Results: The average age of participants was 30.79 years (SD = 6.317). Among 90 women without a history of hormonal contraceptive use, 78.9% had normal USG results, while 21.1% were diagnosed with FAM. In contrast, of the 410 women with a history of hormonal contraceptive use, only 2.2% had normal results, while 97.8% were diagnosed with FAM (29.5% left breast, 30.5% right breast, 37.8% bilateral). Chi-square test results showed a significant association (p = 0.000) between hormonal contraceptive use and FAM incidence.

Conclusion: There is a significant correlation between hormonal contraceptive use and the occurrence of FAM. USG remains the most widely used modality for FAM detection due to its cost-effectiveness and availability across healthcare facilities in Indonesia.

Penggunaan Teknologi Dynamic Digital Radiography (DDR) Pada Skrining Deteksi Dini Tuberkulosis (TBC)

Mega Indah Puspita — 2025-05-31

Background: Tuberculosis is a major public health problem in Indonesia and a global challenge. TB in Indonesia ranks third after India and China, with 824,000 cases and 93,000 deaths per year, or 11 deaths per hour. TB sufferers are not fully aware of the right treatment. Chest radiography or commonly called chest X-ray is one of the main methods used in TB screening. The latest digital radiography technology, Dynamic Digital Radiography (DDR), combines the principles of conventional radiography with advanced technology to produce more dynamic and detailed images. In this study, a chest X-ray examination will be carried out as an early detection screening for TB by utilizing the latest features in digital radiography technology, namely Dynamic Digital Radiography (DDR).

Methods: The type of research is quantitative exploratory approach. Research Population: TB patients using portable mobile X-Ray equipment. Research Sample: Image results of TB screening patients with portable mobile X-Ray totaling 3 patients. Research Steps: preparing research tools and objects, positioning patients for thorax radiography projection, exposure is done during full inspiration and holding breath. Data processing and analysis techniques are carried out by editing, data entry and tabulation.

Results: DDR is able to provide radiographic images with a higher level of sharpness and detail than conventional radiography. DDR is able to show small lung lesions that are difficult to see on conventional images. Small lesions or nodules that indicate the possibility of TB infection are detected more clearly in DDR, DDR is often integrated with AI (Artificial Intelligence) because it can help detect patterns and characteristics of TB disease and is able to show TB risk scores to help diagnose faster and more accurately.

Conclusions: The results showed that DDR detected 100% of abnormalities, while conventional radiography detected 66.6% of abnormalities. This shows that DDR has a significant advantage in terms of detecting smaller or hidden abnormalities, which are often missed in conventional examinations.

Analisis Informasi Citra Anatomi MRI Brain dengan Variasi Flip Angle (FA) Sekuen 3D TOF MRA pada Klinis Tumor Otak

Nabilah Putri Riyadi — 2025-05-30

Background: Brain tumors are abnormal cell mass growths in the brain tissue. MRI can show images of blood vessels without using contrast media called MRA. Flip angel (FA) of MRI scanning parameter that affects the contrast of blood vessel flow and stationary tissue in 3D MRA TOF sequences. This study aims to determine the difference in anatomical image information on 3D MRA TOF with flip angle variations and find the optimal flip angle value.

Methods: This study is an experimental study using 1.5 Tesla MRI modality on 10 clinical patients with brain tumors with 20º and 25º of flip angle variation. The images were assessed by 2 respondents with anatomical assessment of Internal Carotid Artery , Vertebral Artery, Basilar Artery, Anterior Cerebral Artery, Posterior Cerebral Artery, Middle Cerebral Artery, Anterior Communicating Artery, Posterior Communicating Artery dan Tumor Feeding Artery. Analysis data was performed by cross tabulation and wilcoxon test.

Results: Wilcoxon test show the overall anatomical information obtained a significant value (p-value) of 0,000 = p<0,05, meaning that there are differences in anatomical image information of 3D MRA TOF sequences at 20º and 25º flip angle variations. Based on the Wilcoxon test results, the mean rank value obtained by 20o flip angle is 25,50 while 25o flip angle is 27,16.

Conclusions: The flip angle value that is more optimal in displaying anatomical image information is 25º flip angle where more visualized at Vertebral Artery, Basilar Artery, Anterior Cerebral Artery, Posterior Communicating Artery and Tumor Feeding Artery.

Bolus Alternatif Berbahan Termoplastik pada Radioterapi

Rois Rizal Wiguna — 2025-05-30

Background: Unused thermoplastic masks have the potential to be recycled as boluses because the thermoplastic base material is also used as bolus material and has been researched to increase the surface dose. However, before being used as a bolus, it requires processing techniques first. This research aims to determine the design, how it works and test the function of the bolus

Methods: This research is exploratory research. Research was carried out on design, working methods and functional tests in the form of density, homogeneity, surface dose and conformity. The bolus is made and then scanning is carried out on the bolus that has been made. The scanning image obtained is then processed at the TPS to obtain HU, air-gap and surface dose values. The data that has been obtained is analyzed to determine the characteristics of each bolus that has been made. Based on the results of the analysis, it can be seen whether the bolus that has been made meets the criteria for good bolus material.

Results: Thermoplastic bolus is hard, does not crack easily, and does not change shape easily. To produce this bolus, it is done through a process of cutting the mask into smaller pieces, pulverizing to remove holes and produce a dense material, and printing. The bolus can be shaped and positioned as long as it is still warm 2 minutes after printing. Thermoplastic bolus has the potential as an alternative bolus with characteristics of a density value of 30 HU, homogeneity with a standard deviation of ±11, conformity with the highest air-gap of 0.3 cm, and a dose to the phantom surface of 99.1%.

Conclusions: Based on the assessment of the characteristics of the thermoplastic bolus, it has the potential to be used as an alternative bolus. In further research, it is hoped that more efficient manufacturing techniques can be developed with better results and tests that have not yet been carried out.