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OPTIMALISASI CITRA MSCT TRAKTUS URINARIUS MENGGUNAKAN TRACKING DENGAN VARIASI SLICE THICKNESS DAN WINDOW SETTING Nanang Sulaksono; Suryono Suryono; Jeffri Ardiyanto
Jurnal Riset Kesehatan Vol 5, No 1 (2016): Mei 2016
Publisher : Poltekkes Kemenkes Semarang

Kidney disease is a clinical situation which is indicated by the decreasing of kidney functions and MSCT is one of the modalities to diagnose that function. The research was aimed to prove that the use of Tracking with variation in Slice Thickness and window setting was able to produce an optimal image after contrast value analysis was conducted. The method was the experimental research using research planning Pretest-Posttest Control Design. The sampling was chosen consecutively. There were 3 Radiolog and 21 patients on the examination of MSCT abdomen without positive contrast media in Salatiga Public Hospital. The research was conducted from May to July 2015. Research Results, the intervention validity experiment before and after using Tracking with Paired T-Test statistic experiment showed p value 0,000. There were some significant differences. Through Mann Whitney experiment, it was found that there was different result of p value 0,000 (p less than 0,05). There were significant differences in each group. It can be Concluded that The significant difference before and after using Tracking shows that Tracking can be used as an alternative for MSCT uroraphy examination.

TATALAKSANA RADIOTERAPI EKSTERNA PADA KANKER PAYUDARA DENGAN TEKNIK SIMULTANEOUS INTEGRATED BOOSTER (SIB) DI UNIT RADIOTERAPI INSTALASI RADIOLOGI RS KEN SARAS KABUPATEN SEMARANG Ardani Ardani; Edy Susanto; Nanang Sulaksono; Sri Mulyati
Jurnal Imejing Diagnostik (JImeD) Vol 6, No 1: January 2020
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v6i1.5403

Background: Radiotherapy is a cancer treatment method using ionizing radiation. The SIB technique is a technique of providing additional radiation together with the administration of primary radiation. At Kensaras Hospital, booster treatment performed simultaneously with the administration of primary radiation or known as SIB is carried out using the IMRT technique or also known as the SIB IMRT technique. whereas according to Susworo, irradiation techniques on breast cancer are not recommended using the IMRT technique, but should use the FIF technique. The purpose of this study was to determine the governance of radiotherapy and the reasons for choosing the SIB technique.Methods: This type of research is qualitative with a case study approach. Data collection was carried out in December 2018 until May 2019 at Ken Saras Hospital. Result: The results showed that the SIB technique had several advantages, among others: better radiation conformity and able to minimize OAR doses. This is proven by obtaining doses which mostly meet ICRU standards. While for OAR doses it also meets quantec tolerance standards, except the right lung at a dose of 2000 cGy the volume exceeds 30%, which is equal to 34.55%. But the dosage according to the doctor's consideration is still said to be safe. Conclutions: The external radiotheraphy procedure including consulting a doctor, taking CT Simulator data, TPS, verification and treatment. Strengths of the SIB technique: Better irradiation conformity, suppressing OAR doses, reducing toxicity to the skin, only requiring one planning and allowing dose calculation in one planning

ANALISIS INFORMASI CITRA ANATOMI MSCT THORAX DENGAN KASUS EFUSI PLEURA KANKER PARU PADA WINDOW MEDIASTINUM POST KONTRAS MENGGUNAKAN VARIASI NILAI WINDOW WIDTH Tri Puji Hastuti; Yeti Kartikasari; Bagus Abimanyu; Nanang Sulaksono
Jurnal Imejing Diagnostik (JImeD) Vol 6, No 1: January 2020
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v6i1.5562

Background: Malignancy of lung cancer is the biggest cause of pleural effusion. To diagnose lung cancer pleural effusion, a thorax MSCT can be examined. The MSCT parameter that affects image contrast is window width. The purpose of this study was to determine the differences in the anatomical information of thorax MSCT images in the post contrast mediastinal window to the use of window width range 350-600 HU values in cases of lung cancer pleural effusion, and to determine the appropriate window width value to obtain optimal anatomic image information on Thorax MSCT in cases of lung cancer pleural effusion.Methods: This type of research is quasi experimental. The research was conducted at the Radiology Installation of the Dr. Moewardi Hospital. The data were 60 images of the post contrast mediastinal window thorax MSCT axial slice from 10 patients with 6 window width variations (350 HU, 400 HU, 450 HU, 500 HU, 550 HU, 600 HU). An image assessment was conducted by 3 respondents regarding the resulting of 5 anatomical information. Data analysis used Friedman statistical test.Results: The results showed that there was a difference in the anatomical information of the thorax MSCT in the post contrast mediastinal window to the window width variation in cases of lung cancer pleural effusion with a significance level of p value 0,000 (ρ 0.05). Differences in anatomical image information occur in the anatomy of the aorta, limits of pleural effusion with lesions and clarity of lesions, where as there is no difference in anatomy of the right and left primary bronchus. The optimal use of the window width value for thorax MSCT in the post contrast mediastinal window cases of lung cancer pleural effusion is WW 350 HU with a rank value of 4.61.Conclusions: This study shows that the use of 350 HU window width produces better anatomical image information than the use of other window widths in the case of pleural effusion of lung cancer.

THE OPTIMIZATION OF MSCT OF URINARY TRACT USING TRACKING WITH FILTERS VARIATION Nanang Sulaksono; Agustina Dwi Prastanti; Vederica Farida Candra
Jurnal Imejing Diagnostik (JImeD) Vol 5, No 1: January 2019
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v5i1.4011

Backgroud: Kidney disease is a clinical situation which is indicated by the decreasing of kidney functions and MSCT is one of the modalities to diagnose that function. Aim to identify the differences in image information with filter variation abdomen medium smooth and Mediastinum Standard.Methods: The method was the experimental research using research planning Post Test Only Group Design. The sampling was chosen consecutively. There were 3 Radiolog and 32 citra on the examination of MSCT abdomen without positive contrast media in Salatiga Public Hospital.Results :The intervention validity experiment after a tracking filter with variations, kruskal Wallis test results. There are meaningful differences shows vlue of p value 0,000 (p0,05), so that continued analysis of the Mann Whitney. The results of the analysis of the Mann Whitney pointed out that there is a difference between real or significant group of filter Medium Smooth Abdomen with Abdominal filter Medium Sharp/Mediastinum Standard Sig0.05 p value 0.000).Conclusion: a variation of the filter is able to identify the existence of a difference image information tracktus optimal unirarius MSCT abdomen after tracking by using the best filtr Medium Sharp Abdomen/Mediastinum Standard.

Perbandingan Informasi Citra Potongan Axial T2 Antara Turbo Spin Echo (TSE) Dengan Half-Fourier Aquisition Single-Shot Turbo Spin Echo (HASTE) Pada Pemeriksaan Magnetic Resonance Cholangiopancreatography (MRCP) Adilfi Amalia Yuniar; Dartini Dartini; Rasyid Rasyid; Bagus Dwi Handoko; Nanang Sulaksono
Jurnal Imejing Diagnostik (JImeD) Vol 7, No 2: JULY 2021
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v7i2.7464

Backgroud: MRCP is a non-invasive imaging examination, which is used for the evaluation of biliary tract, pancreatic duct, and gallbladder. Pulse sequences which can be used to visualize organs in MRCP on T2 weighting is using a fast pulse sequences such as sequences TSE or Haste. The purpose of this research was to knowing the difference image information between T2 axial TSE with Haste and where better to use between the two sequences on axial T2 MRCP examination.Methods: This type of research is experimental observational approach, it has been carried out in the best MRI 1.5 Tesla at RSU Haji Surabaya. Sample used were 5 patients. Each patient performed two pieces of axial T2 sequences in which the TSE and Haste. Furthermore, the image submitted to the three doctors radiologist to fill out a questionnaire that has been provided to assess the image consisting of the liver, gallbladder, common bile duct (CBD), pancreas, intrahepatic duct and an assessment of the artifacts.Results: The results of analytical assessment Wilcoxon test, for the entire anatomy with ρ value of 0.002 which means that ρ 0.05, and the artifacts show the ρ value of 0.006, which means ρ 0.05. This proves that there are differences in image information between T2 axial TSE with T2 axial Haste the MRCP examination. At each of anatomy, liver has ρ value of 0,071 (ρ 0.05), gallbladder has ρ value of 0.317 (ρ 0.05), CBD has ρ value of 0.003 (ρ 0.05), pancreas has ρ value of 0.014 (ρ 0.05) and intrahepatic duct has ρ value of 0.004 (ρ 0.05). Based on the mean rank statistical test results show sequence Haste better in generating image information on the whole anatomy, but in each of anatomy based on the mean rank of gallbladder both sequences are equally good in showing gallbladder, whereas to display the liver, CBD, pancreas, and intrahepatic duct, the results showed T2 Haste mean rank better, it is because it has the characteristics of high Haste T2 signal intensity and better in reducing motion artifacts.Conclusion: Wilcoxon test analysis results expressed Ha accepted, meaning that there is a difference between the image information pieces axial T2 TSE with Haste the MRCP examination. The mean rank shows Haste superior to TSE, this is because the artifacts on TSE and therefore contributes to the respondent's assessment, other than that Haste has a high signal intensity so that it can show more clearly ducts.

PROSEDUR PEMERIKSAAN LOPOGRAFI DENGAN KLINIS SUSPECT COLON CARCINOMA Rosy Amelia Azhari; Nanang Sulaksono; Agustina Dwi Prastanti
JRI (Jurnal Radiografer Indonesia) Vol. 5 No. 2 (2022): November
Publisher : Perhimpunan Radiografer Indonesia (PARI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55451/jri.v5i2.129

ABSTRACT Background :The lopographic examination according to Lampignano and Kendrick (2018) uses barium sulfate contrast media which is inserted through the stoma, using plain photos, AP/PA, Lateral, Oblique, post evacuation. Installation of Radiology Hospital Prof. Dr. Margono Soekarjo Purwokerto using a non-ionic water soluble contrast media mixed with NaCl, inserted into the proximal stoma and anus with plain photos, AP, Lateral. The purpose of the study was to determine the lopographic examination procedure, the reasons for using water soluble contrast media, to find out anatomical information from the AP and Lateral. Methods :This research used qualitative approach with a case study. Data collection were used observation, interviews, documentation. Research respondents were patients, radiographers, radiologist, and dispatching doctors. Data analysis with interactive analysis model. Result : Showed that the lopographic examination was aimed at evaluating the colon after colostomy and chemotherapy. Patients undergo special preparation. The water soluble contrast medium was mixed with NaCl in a ratio of 1: 4 because it was safer than barium sulfate. The reason for insertion of contrast media through the proximal stoma and anus is the absence of a stoma to the distal colon. Anatomical information from the plain photo is the distribution of air in the colon, the AP projection looks contrast to fill the ascending colon, transverse colon, descending colon and superpositioned sigmoid colon. Laterally, the sigmoid colon and rectum are seen. Diagnostic information was not found in colonic carcinoma residif cells.

ANALISA PERBEDAAN INFORMASI DIAGNOSTIK CT SCAN KEPALA PADA KASUS STROKE ISKEMIK DENGAN PILIHAN KOMBINASI SLICE THICKNESS DAN INTERVAL RECONSTRUCTION Mami Dwi Yan; Nanang Sulaksono; Jeffri Ardiyanto
JRI (Jurnal Radiografer Indonesia) Vol. 4 No. 2 (2021)
Publisher : Perhimpunan Radiografer Indonesia (PARI)

ABSTRACT Background: Stroke is a diseas that has a high mortality rate as the third most common disease that causes death in the world. To diagnose the location and type stroke, a neuro imaging examination is need, which is by examining the CT Scan of the head. The purpose of this study was to determine differences in diagnostic information on CT scan of the head in cases of ischemic stroke with a choice combination of 3 mm slice thickness with 1.5 mm interval reconstruction and 2 mm slice thickness with 1 mm interval reconstruction, and to find out which combination is the most optimal in producing diagnostic information in cases of ischemic stroke. Methods: This type of research is quantitative research with experimental approach. The study was conducted at Telogorejo Hospital Semarang. The sampel in this study were 10 patients with expertise results of ischemic stroke. The resultan data was 10 head scan radiographs with ischemic stroke and each radiograph is reformatted with combination of 3 mm slice thickness with 1.5 interval reconstruction and 2 mm slice thickness with 1 mm interval reconstruction. Assesment of diagnostic information data was done by 3 respondents. before data analysis, first kappa test was done to three respondents and then tested wilcoxon. Result :The result of this research is the difference of diagnostic information between combination of 3 mm slice thickness with 1.5 mm interval reconstruction and 2 mm slice thickness with 1 mm interval reconstruction. A combination of 2 mm slice thickness with 1 mm interval reconstruction with mean rank 21.00 is the most optimal combination for head scan with ischemic stroke cases.

ANALISIS VARIASI WINDOW WIDTH TERHADAP INFORMASI CITRA ANATOMI MSCT STONOGRAFI Muhammad Izzudin; Hermina Sukmaningtyas; Nanang Sulaksono
JRI (Jurnal Radiografer Indonesia) Vol. 4 No. 2 (2021)
Publisher : Perhimpunan Radiografer Indonesia (PARI)

ABSTRACT Background : Multi Slice Computed Tomography is a diagnostic imaging method that can display cross section anatomy in the axial, sagital, and coronal areas. MSCT Stonography imaging both visualizes the anatomy of the urinary tract and stone pathology supported by the presence of ureter tracking techniques and without using contrast media. On this method, the appropriate window width will produce an optimal anatomical picture. The Study aims to determine the effect of window width on anatomical image information on MSCT Stonography. Methods : Type of research is quantitative experimental approach, conducted in January-February 2020 in Hasan Sadikin Bandung hospital, Bandung. Research with variations in window width 300 HU, 350 HU, 400 HU, 450 HU, and 500 HU on MSCT stonography og 10 patients. Criteria’s patients is patients with clinical kidney stones, willing to be a research sample. Result imagery rated two respondents, include parenchymal kidney, pelvic calices kidney, ureters, vesica urinary, and stones kidney. Then do Kappa test continued testing Friedman to know the highest mean rank and the influence og the window width oh the image og MSCT stonography. Results : Based on the result of the Friedman statistical test overall anatomy obtained significance value (p-value) = 0.000 < 0.05 means that there is an influence of window width value, the contrast resolution will increase and the better the firm boundary, but the resulting image will be more radioluscent. Based on Friedman’s mean rank test result obtained the highest mean rank of 3,54 in a variation of window width 300. The most optical window displays anatomy information using window width 300. Conclussion : There are difference in anatomical image information of MSCT stonography among 5 variation window width on examination MSCT stonography. Window width 300 HU is better at anatomy information on MSCT stonography to show better contrast, crisp sharpness, no blur image.

TEKNIK SPLIT BOLUS TERHADAP INFORMASI ANATOMIS PADA PEMERIKSAAN CT SCAN UROGRAFI Amelia Rizqi Utami; Nanang Sulaksono; Sigit Wijokongko
JRI (Jurnal Radiografer Indonesia) Vol. 5 No. 1 (2022)
Publisher : Perhimpunan Radiografer Indonesia (PARI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55451/jri.v5i1.109

Background : The split bolus technique in CT Scan urography is an intravenous contrast media insertion technique by combining two phases, namely the nephrography phase and the excretory phase in one scan acquisition. In general, the CT Scan urography examination uses 3 phases, non-contrast phase, the nephrographic phase, and the excretory phase. In the role of the split bolus technique, the combination of two phases, namely the nephrographic and excretory phases. The purpose of this study was to explain the split bolus technique and the role of the split bolus technique on anatomical information in CT Scan urography. Methods : This type of descriptive research using a literature review approach. The keywords used are "Split-bolus", "CT Scan Urography". Articles were obtained based on inclusion and exclusion criteria and 7 relevant scientific articles were obtained and were used as literature sources. Data processing through article extraction. Result : The split bolus technique in CT Scan urography examination is a technique of intravenous contrast media that combines two nephrographic and excretory phases in one image acquisition with an average flow rate of 1.5 ml - 3 ml / s. This technique uses a non-ionic iodine contrast medium with a volume of 90 ml - 135 ml and a concentration of 300 mg/ml-370 mg/ml. The role of the split bolus technique on radiation dose and anatomical image information is due to the merging of the two phases in one scan which addresses the anatomy of the urinary system. In addition, the split bolus technique when combined with several reconstructions is able to increase contrast resolution and increase organ enhancement. In this technique, it is better to use the addition of a reconstruction algorithm such as 3D MIP, so that the anatomical image information obtained is more optimal.

OPTIMALISASI KUALITAS CITRA ANATOMI DENGAN VARIASI IDOSE DAN INTERATIVE MODEL RECONTRUCTION (IMR) PADA MSCT UROGRAPHY NON KONTRAS DENGAN TEKNIK TRACKING Nanang Sulaksono; Ary Kurniawati
JRI (Jurnal Radiografer Indonesia) Vol. 6 No. 1 (2023): Mei
Publisher : Perhimpunan Radiografer Indonesia (PARI)

Show Abstract | Download Original | Original Source | Check in Google Scholar

ABSTRAK Background: The urinary tract (urinary system) consists of the two kidneys and ureters, the urinary bladder, and the ureters. There are several ways to examine abnormalities in the urinary tract radiologically. including the current CT scan, CT Scan (MSCT) is one of the modalities to evaluate and diagnose urinary tract disorders. MSCT of the urinary tract without using positive contrast media is able to identify images of the urinary tract in cases of urolithiasis. iDose and Interative Model Reconstruction (IMR) are the second generation of IR algorithms from the previous generation, namely iDose. This technology can also lower the dose to the patient and also improve the quality of the resulting image. Method: This type of research is an experiment with an observational approach with comparisons. This type of research is an experiment with data obtained from a comparison of noise values and the quality of anatomical images from tracking images with iDose and IMR variations. And an assessment was carried out by 3 radiologists. Place of data collection in radiology RSUD RAA Soewondo Pati. Time for data collection From April to November 2022. in assessing anatomical images using statistical tests. Data analysis was carried out using the Wilcoxon statistical test method because the data were ordinal with paired groups. The Wilcoxon statistical test was used to test the hypothesis and see the level of difference in anatomical image information. The level of significance (level of significance) is 95% or α> 0.05 and is done by assessing the p-value. For a significant level of assessment p <0.05 then Ho is rejected and p> 0.05 then Ho is accepted. Results: Friedman test on each anatomical part of the urinary tract system on Non-Contrast Urography MSCT images with Tracking Techniques with iDose 1-6 and IMR 1-3 variations, there are differences in anatomical image information with a p value of .000 (p <0.05). In the anatomy of the renal parenchyma, the highest mean rank is iDose 3 with a value of 8.15. In pelvic anatomy and kidney calices, the highest mean rank is at iDose 6 with a value of 8.05. In ureteral anatomy, the highest mean rank is iDose 3 with a value of 8.05. In the anatomy of the perirenal space, the highest mean rank is iDose 3 with a value of 8.20. Based on the results of the mean rank Friedman test to find out the optimal I Dose and IMR values, it was obtained iDose 1 with a mean rank value of 4.65, iDose 2 with a mean rank value of 4.95, iDose 3 with a mean rank value of 8.3, iDose 4 with a mean rank value of mean rank 6.4, iDose 5 with a mean rank value of 6.55, iDose 6 with a mean rank value of 7.75, IMR 1 with a mean rank value of 1.65, IMR 2 with a mean rank value of 2.05, and IMR 3 with a mean value rating 2.7. Conclusion: Changes in the values of iDose and IMR variations affect the anatomical image information of Non-Contrast MSCT Urography with Tracking Techniques, this is based on the results of the mean rank Friedman test performed on each anatomy of the renal parenchyma, pelvic calices, ureters and perirenal space which shows a difference. Based on the results of Friedman's mean rank test conducted on the entire anatomy of the renal parenchyma, ureters, and perirenal space, it showed that the optimal iDose and IMR variation values were iDose 3 with a mean rank value of 8.3.

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