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EFFECT OF RECEIVE BANDWIDTH’S VARIATION TO SIGNAL TO NOISE RATIO (SNR) AND CONTRAST TO NOISE RATIO (CNR) ON MRI EXAMINATION OF CERVICAL WITH T2 WEIGHTED FAST SPIN ECHO SEQUENC HERNIA NUCKLEUS PULPOSUS (HNP) CASE Muhammad Raizal Rais; Bagus Abimanyu; Darmini Darmini
Jurnal Imejing Diagnostik (JImeD) Vol 4, No 2: July 2018
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v4i2.4009

Background : The received bandwidth parameter is a parameter that can affect the value of SNR and CNR. The use of bandwidth value on the MRI 1.5 Tesla for cervical MRI examination with T2 Weighted Fast Spin Echo sequence axial used a value of 27.87Hz/px. By doing the variation of bandwidth, the quality of SNR and CNR image is different. The purpose of this study is to determine the effect of bandwidth variation on SNR and CNR. To know the optimal value of receive bandwidth variation on cervical MRI examination with T2 Weighted Fast Spin Echo sequence in Herniated Nuckleus Pulposus (HNP) case.Methods : This type of research is qualitative research with experimental approach. This study was conducted using MRI GE 1.5 Tesla at Bethesda Hospital Yogyakarta. Data in the form of 10 images of cervical MRI T2 FSE axial slice of 10 patients with 3 received bandwidth variation (20.83Hz / px, 27.87Hz / px and 31.25Hz / px). To determine SNR and CNR values, Region of Interest (ROI) with size 1mm2 were placed on Discus Intervertebralis, Cerebrospinal Fluid, Spinal Cord and Ligament Flavum. And to get the average value of the signal then the averageof signal was divided by the standard deviation from the background. The analysis was done by linear regression test and friedman mean rank test.Results : The result of research shows that there is influence between receive bandwidth variation on SNR and CNR cervical. The value of 20,83Hz/px receive bandwidth variation in cervical MRI examination with T2 Weighted Fast Spin Echo sequence result in optimal SNR and CNR value.Conclusion : There was the effect of the receive bandwidth of the SNR and CNR on MRI cervical sequences T2WI FSE axial. Receive Bandwidth optimum value in MRI cervical T2WI FSE axial is 20,83Hz/px.

PERFOMANCE TEST OF MRI MACHINES IN THE PROVINCE OF BALI Gusti Bagus Yudhi Jaya Putra Atmaja; Gatot Murti Wibowo; Bagus Abimanyu
Jurnal Imejing Diagnostik (JImeD) Vol 4, No 2: July 2018
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v4i2.4000

Backgroud: The research of performance test of MRI machines were done by doing performance test of nine different parameters in three hospitals in the province of Bali, where in two of these three hospitals are having troubled MRI machines which directly affected the image quality and therefore this research is also aimed to find out the performance of MRI machines in some hospitals in the province of Bali and intended as a baseline data if there will another test.Methods: This research is a quantitative study with survey approach. The tools and materials for this research were three MRI machines, which was consisted of two 1,5 Tesla machines and a 0,3 Tesla machine, phantom ACR, and MRI head coil. The data were collected by doing nine MRI performance testing procedures with ACR (2015) as a guideline and then the data were analyzed using international standards issued by ACR (2015).Results: Visual checklist test result of all the hospitals get 12 pass every day from the first day to the twentieth day. SNR test in Badung Regional General Hospital obtain measurement results of 268.17 and in The Board Of Tabanan General Hospital at 15.78 and at Sanglah Central General Hospital of 2.4. To test the artifact analysis only in The Board Of Tabanan General Hospital only found one type of artifact is the artifact geometric distortion. In testing the high contrast resolution in Sanglah Central General Hospital and Badung Regional General Hospital get the same result, namely insert a separate resolution of up to a third group, and the The Board Of Tabanan General Hospital insert a separate resolution to the second group. The test results in low contrast resolution Sanglah Central General Hospital and Badung Regional General Hospital get the same result, namely that there are 10 spokes are visible, then the The Board Of Tabanan General Hospital number of spokes that appear are 9 spokes. In testing the slice thickness accuracy in Sanglah Central General Hospital get the standard deviation of measurement of 5.12mm and in Badung Regional General Hospital get the standard deviation and the measurement of 0.64mm in The Board Of Tabanan General Hospital get the standard deviation of measurement of 0.48mm. Results of the geometric accuracy test in The Board Of Tabanan General Hospital has a difference measurement of 4.2mm X axis, Y-axis of 1.3mm, and has no difference in the Z-axis, in Badung Regional General Hospital has a difference of X-axis measurement of -3.1mm, have no difference in the Y axis the Z axis of 2mm, in Sanglah Central General Hospital has a difference measurement of 1.36mm X axis, Y-axis and Z-axis of 0.39mm for -3.53mm. The test results slice position accuracy in Sanglah Central General Hospital get the standard deviation measurements for -1.33mm, in The Board Of Tabanan General Hospital of 0.85mm, and in Badung Regional General Hospital of -0.3mm. For the test setup and table position accuracy throughout the hospital to get the same measurement is 5mm.Conclusion: Out of nine parameters in the test : only four parameters, which were high contrast resolution test, low contrast resolution test, slice position accuracy test, and setup and table position accuracy test, that met the international standards in all hospitals, whereas all the hospital didn’t meet the international standards in geometric accuracy test. There were two hospitals that didn’t meet the international standards in signal to noise ratio test, while one hospital didn’t meet the standards in artifact analysis test and slice thickness accuracy test.

Analisis Informasi Anatomi pada Pemeriksaan CT Scan Ankle Joint Menggunakan Protokol CT Abdomen Dan Protokol CT Ankle Joint di Instalasi Radiologi Rumah Sakit Gading Pluit Jakarta Gunawan Khairul Anam; Bagus Abimanyu; Edy Susanto
Jurnal Imejing Diagnostik (JImeD) Vol 1, No 2: July 2015
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v1i2.3154

Backgroud: In Radiology Installation of Gading Pluit Jakarta Hospital, CT Scan of the ankle joint uses abdomen CT protocol because it produces image quality that is considered to be able to diagnose and provide adequate information, although in Gading Pluit Jakarta Hospital there is a choice of CT protocol with Ultra High Resolution (UHR). The purpose of this study was to determine the difference of anatomical information on ankle joint CT scan between abdomen CT protocol and ankle joint CT protocol at Gading Pluit Jakarta Hospital and which protocol is better between UHR ankle protocol and abdomen protocol.Methods: This type of this research was an experimental study. The study was conducted by performing two times of scanning with different protocols such as abdomen protocol and ankle joint protocol on ankle joint CT scan examination. The image was assessed by seven radiology physicians by viewing the information of the image. Data were analyzed statistically with Wilcoxon test.Results: The results of this study showed that there was significant difference between abdomen protocol and UHR ankle joint protocol, with Wilcoxon p.value = 0,00 (p 0,05) and on ankle joint CT Scan examination, UHR ankle joint protocol was better than abdomen protocol so that the UHR ankle protocol was well applied in daily examination on CT scan of ankle joint.Conclusion: There was difference between the abdomen CT protocol and ankle joint CT protocol (UHR) in Radiology Installation of Gading Pluit Jakarta Hospital. The ankle CT protocol (UHR) was better than the abdomen CT protocol on ankle joint CT scan examination in Radiology Installation of Gading Pluit Jakarta Hospital.

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.

PEMERIKSAAN MRI PELVIS DENGAN MENGGUNAKAN ULTRASONIC GEL PADA KASUS ENDOMETRIOSIS DI INSTALASI RADIOLOGI MAYAPADA HOSPITAL JAKARTA SELATAN Legif Leboka Sepra; Siti Masrochah; Bagus Abimanyu
Jurnal Imejing Diagnostik (JImeD) Vol 5, No 2: July 2019
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v5i2.4474

Introduction: Pelvic MRI examination in endometriosis cases does not theoretically use an ultrasonic gel that is inserted into the vagina and rectum, but also for sequences used without using the T1 sequence. Sagittal cut fat suppression. Radiology Installation Mayapada Hospital, South Jakarta for Pelvic MRI examination with Endometriosis cases using Gel and T1_SPIR sequences from these differences the authors are interested in exploring information about Pelvic MRI examination in Endometriosis cases at Radiology Installation Mayapada Hospital, South Jakarta with the aim of knowing the role of gel and sequencing of T1_SPIR Sagittal pieces.Method: This type of research is qualitative research with a case study approach. The method of data collection is done by observation, in-depth interviews with radiographers, radiology specialists and sending doctors and documentation. Data analysis is done by an interactive model, then the data is presented in the form of the narrative text so that conclusions can be drawn.Results: The results showed that Pelvic MRI examination using Ultrasonic Gel in Endometriosis Cases in Mayapada Hospital Radiology Installation in South Jakarta used ultrasonic gel in the 50cc and 150cc vaginal organs, the sequences used were: T2W_TSE, T2W_SPIR, T1_SPIR, T1W, T2_FFE on Sagittal snippets, T2W_TSE, T2W_SPAIR, T1W_SPIR on coronal chunks, T1W_TSE, T1W_TSE_SPIR, T2W_TSE on axial chunks and DWI_3b_RT SENSE on axial chunks and SSh_URETER. The reason for using ultrasonic gel on MRI examination in the Pelvis at the Mayapada Hospital Jakarta Radiology Installation is to see a clear difference between normal tissue and pathological tissue and expressly demarcate organ boundaries and play a role in widening the vaginal cavity and rectum. The reason for adding the sagittal cut T1_SPIR sequence in the case of Endometriosis at the Mayapada Hospital Radiology Installation in South Jakarta is to show lesions suspected of blood or other intensity and to ensure bleeding.

Analisis Informasi Citra Anatomi Fase Late Artery dengan Variasi Time Scan Delay pada Pemeriksaan MSCT Abdomen Bagus Abimanyu; Luthfi Rusyadi; Taufiq Taufiq
Jurnal Imejing Diagnostik (JImeD) Vol 3, No 1: January 2017
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v3i1.3187

Background: MSCT Abdomen late arterial phase is a radiological examination to evaluated enhancement in hypervascular lesions, stomach, bowel, pancreas parenchyma, spleen and kidney outer cortex. All the structures get bloodsupply of the artery will show an optimal increase (Smithuis, 2014). Smithuis (2014) used time scan delay 15-20 seconds. However in the Abdomen MSCT examination in the late arterial phase of Radiology Hospital Dr. Kanujoso Djatiwibowo Balikpapan used the different time scan delay. This study aimed to determine differences in contrast enhancement with time scan delay variation of contrast media and to determine the optimal time scan delay in the examination of the Abdomen MSCT late arterial phase.Methods: The research type is quantitative experimental approach. Data are taken in October and November 2016. The research population of abdomen MSCT examination clinical intra-abdominal mass cases. Total sample are 18 people with a predetermined inclusion criteria. Time scan delay variation used are 10 seconds, 15 seconds, 20 seconds. evaluated with respondents the data is processed with statistic analysis by using different test Kruskal-Wallis followed by post hock Mann-Whitney and to get the most optimal assessment visits of mean rank the Kruskal-Wallis test.Result: The results obtained p value 0,001 (p 0,05), there are shown significant differences between time scan delay 10 seconds, 15 seconds, 20 seconds at Abdomen MSCT examination in the late arterial phase of Radiology Dr. Kanujoso Djatiwibowo Balikpapan Hospital. An optimal time scan delay on Abdomen MSCT examination late arterial phase is 10 seconds premises ROI tracking on descenden aorta. From the results of tests conducted using the Kruskal-Wallis test values mean rank at the time scan delay of 10 seconds is 84,75.Conclusison: There is a difference significant anatomical image information between the time scan delay 10 seconds, 15 seconds, 20 seconds. on MSCT Abdomen examination artery in the late phase of Radiology Dr. Kanujoso Djatiwibowo Balikpapan Hospital. assessment results are tested using the Kruskal-Wallis test followed Mann-Whitney post hock obtained p value 0.001 (p 0.05), meaning that there is a difference between the third anatomical image information with time scan delay variations. Time delay optimal scan on Abdomen MSCT examination late artery phase that time scan delay 10 seconds by tracking ROI on descenden aorta. From the results of tests conducted using the Kruskal-Wallis test values mean rank at the time scan delay of 10 seconds 84.75, 56.62 ie 15 seconds, 20 seconds, namely 22.12.

Rancang Bangun Alat Bantu Fiksasi dengan Penanda Waktu Eksposi Untuk Pemeriksaan Radiografi Abdomen Akut Siti Masrochah; Yeti Kartikasari; Bagus Abimanyu
Jurnal Imejing Diagnostik (JImeD) Vol 1, No 1: January 2015
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v1i1.3151

Backgroud: Limitations in a radiographic projection of the Left lateral decubitus (LLD) ussually challanges most of the Radiografers who intent to apply the technique toward patients with acute abdoment clinical cases. Related problems that occasionally come up with the LLD projection are the fixed patient positioning and the waiting time it takes to keep patient in the same position. The poor quality of the LLD radiograph and less imaged optimalisation of the free-air below the right diapragm lead to a dificult radiological interpretation. The study aims to design an aided patient fixation tool with its controlling timer used for the LLD projection; and to examine the the functional performance of the tool.Methods: the research is qualitative approached with an experimental study. Several steps following the reseach are creation of the master plan designs and selection of materials that should be used to develop an appropriate aided patient fixation tool with controlling timer for LLD projection; evaluation of the 5 designed tool system components (seated patient, cassette holder, safety belt, electronic sensored movement, andthe timer); and qualitative testing of the tool function and veryfication. The 6 aspects of tool performances have been decided to be complianced indicators whereas 5 observers (expert Radiographers) blended in the evaluation of the aided tool, and the tool has firmed to meet its requirement if the total observer’s score is greater and equal to 2,00Results: In general, the resulted tool perfomance testing fulfilled the requirements of the tool functions as it used for some radiographic procedures of the acute abdoment-LLD projection. The tool performance scores of convenince and reliability equipment showed at 2,25 and 2,75 which meant that a general radiographic quality was looking good without any presense of the artifacts. Morover, the scores for timer and censored devices were 2,70 and 2,65 recpectively, by this clearly described a proper function of timer control and indicator components. The total score for radiation safety evaluation contributed to the higest score amongst all aspects being assessed that was 2,80.Conclusion: The design of the aided patient fixation tool with controlling timer for LLD projection has not only met functional requirements but it has also proven to subtitute some limitations about maintaning good image quality when applied the LLD projection. Radiologic expertation on the LLD-radiograph of the acute abdoment obviously contributed to optimal clinical information

Analisis Pembobotan T2 Turbo Spin Echo (TSE) brain MRI Potongan Axial dengan Penggunaan Sensitivity Encoding (SENSE) dan Tanpa Penggunaan Sense : Evaluasi pada Signal to Noise Ratio (SNR) dan Scan Time Fani Susanto; A. Gunawan Santoso; Bagus Abimanyu
Jurnal Imejing Diagnostik (JImeD) Vol 2, No 2: July 2016
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v2i2.3174

Background: On examination brain MRI often finds non-cooperative patients, requiring rapid acquisition techniques. The parallel imaging sensitivity encoding (SENSE) technique utilizes spatial RF coated phased array information to reduce acquisition time by reducing the K space sampling line to produce good quality and spatial resolution, but has a limitation of signal-to-noise ratio (SNR) reduction. SENSE is used with MRI sequence pulses one of them turbo spin echo (TSE). The purpose of this study was to determine the difference of SNR and scan time on TSE T2 weighting brain MRI axial slices between use SENSE and without SENSE.Methods: This research is quantitative study with experimental approach. The data were collected from May to June 2016 at the Radiology Installation of Premier Bintaro Hospital by calculating the SNR through the software for the region of interest (ROI) and calculating the scan time through the scan timer on the workstation monitor. Data analysis was done by statistical test with SPPS 16 application using paired T-test and descriptiveResults: From the result of statistical test, it is known that SNR at TSE T2 weighting between with and without SENSE is obtained p-value 0,000 (p 0, 05). This is because the encoding of the both image are different, On TSE T2 weighting image without SENSE there is the use 1800 pulses approaching the effective TE so the shallow gradient produces maximum echo, while on TSE T2 weighting with SENSE there is a reduction of phase encoding row in K space and the presence of g-factor causes the SNR to decrease. From descriptive analysis result, is known that scan time on TSE T2 weighting between with and without SENSE usage is obtained by reduction of scan time for 1 minute 24 seconds (49, 01%). This is because the acquisition technique between the both image are different, on the TSE T2 weighting without SENSE there is ETL in charging K space, whereas on the TSE T2 Weighting with SENSE there is R-factor causing the sampling not to fill all K space so that scanning time is reduced.Conclusion: There are SNR and scan time differences on TSE T2 weighting brain MRI of the axial slices with SENSE and without SENSE usage.

Noise Citra dan Estimasi Dosis Radiasi dengan Aktifasi Sistem Automatic Exposure Control pada Pemeriksaan Computed Tomography Kepala Rini Indrati; Azlan Yazid; Bagus Abimanyu
Jurnal Imejing Diagnostik (JImeD) Vol 1, No 2: July 2015
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v1i2.3156

Background: Of the ways to maintain optimum image quality and reduce the intensity of radiation to patients is optimizing the value of tube current (mAs) using parameter of Automatic Exposure Control (AEC) or mA modulation. But at the fact in hospital, protocol parameter Automatic Exposure Control (AEC) is not activated or OFF on head computed tomography examination.Methods: This study was a quatitative experimental study. Subject of this study was head phantom. Phantom scanned with four treatments, the activation parameters was sure exp.3D-high quality, sure exp.3D-standard, sure exp.3D-low dose and AEC-OFF. Noise was analyzed using the standard deviation of the CT Number. The ROI of approximately 5 mm2 the intracranial area which is divided into three quadrants namely the anterior region, central region and posterior region of neck which is uniform are aof phantom.Results: The results showed significant differences when parameter automatic exposure control was activated and disabled or AEC-OFF with p value was 0.003 (0,05). Furthermore, based on the scanning results in a change of radiation dose estimation to the highest doses value of the activation parameters of automatic exposure control and the lowest dose when parameter automatic exposure control deactivated or AEC-OFF.Conclusion: Activation parameters of automatic exposure control (sure exp. 3D) on a head CT examination image noise tends to decline and give a higher radiation dose than when parameter automatic exposure control deactivated or AEC-OFF.

PENGUKURAN NILAI METABOLIT PADA PENGGUNAAN VARIASI NILAI TIME ECHO PEMERIKSAAN MAGNETIC RESONANCE SPECTROSCOPY OTAK Agi Febrian Trihadijaya; Bagus Abimanyu; Darmini Darmini
Jurnal Imejing Diagnostik (JImeD) Vol 5, No 2: July 2019
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v5i2.4476

Background : Application of MRS itself to measure the N-Acetyl Aspartate (NAA) content in tumour, stroake and epilepsy. Contents of NAA has important role in the central nervous system. Examination of MRS itself should be included to support the patient diagnose. Time echo is an important parameter which affect the metabolite spectrum. So, measurement of metabolic value using variants of TE which is 35, 144, 288 ms, are the main idea. The purpose of this research to know the measurable metabolic which use of variants of TE and to know which TE has show the smallest difference with normal metabolic value.Methods : This research is a quantitative descriptive method. Reasearch subject is Radiographer which has competence dan enough experience in MRI. Research samples using 10 person who become the research probandus. The acquisition is do three times on right temporal lobe with TE value 35, 144 and 288 ms. Another parameter which controlled is TR 2000 ms, Single Voxel Spectroscopy (SVS) acquisition sized 31.7mm3 with Point Resolved Spatial Selection (PRESS) pulse sequence. Measurable metabolic aspect which will be evaluate is N-Acetyl aspartate (NAA), Choline (Cho) and Creatine (Cr). Data processing and analysis is do by calculate the spectroscopy spectrum intensity so obtained the measurable metabolic value then using univariate analysis or descriptive analysis.Results : Results of measurable metabolites is the longer TE use so the metabolic spectrum will be decrease on NAA (35 ms: 8.2, 144 ms: 7.3, 288 ms: 5.4), Cr (35 ms: 6.8, 144 ms: 5.8, 288 ms: 3.8) and Cho (35 ms: 6.9, 144 ms: 6.0, 288 ms: 4.4). Then on the calculate of metabolic value difference with normal metabolic value, the longer TE use so the difference will be increase on NAA (35 ms: 1.8, 144 ms: 2.7, 288 ms: 4.6), Cr (35 ms: 1.2, 144 ms: 2.2, 288 ms: 4.2) and Cho (35 ms: 0.1, 144 ms: 1.0, 288 ms: 2.6).Conclusion : So can be assumed that using TE 35 ms on MRS will obtain the metabolic spectrum which close to normal metabolic value. But, short TE unable to show the Lactate spectrum in case of brain tissue abscess, so it’s required to scanning using TE 35 ms and 144 ms or 288 ms as comparison to get more accurate measurable metabolic value.

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