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Efektifitas Penambahan Source to Image Distance (SID) terhadap Penurunan Dosis Radiasi pada Pemeriksaan Radiografi Cranium Angga Yosainto Bequet; Panji Wibowo Nurcahyo; Akhmad Haris Sulistiyadi
Jurnal Imejing Diagnostik (JImeD) Vol 8, No 1: JANUARY 2022
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v8i1.8043

Background: Cranial radiographs are routinely made in 2 projections, namely Antero Posterior (AP) and Lateral with a minimum distance of 100 cm from the radiation source to the image receptor. In addition, it has been shown that increasing the SID from 40 to 48 inches reduces the skin dose even when the requirement for an increase in mAs is considered. A 44-inch or 48-inch SID is recommended where departmental equipment and protocols allow. This study aims to determine the effectiveness of the addition of SID to decrease the radiation dose on cranium radiographs.Methods: This type of research is a pre-experimental quantitative. The study was conducted at the radiology laboratory of Diploma Three Program of Radiology Purwokerto, Semarang Health Politechnic of Ministry of Health. The research subject is a Radiographic Xray Cranial Phantom. At the time of exposure, the radiation dose was measured and the resulting image was measured CNR value.Results: The results of radiation dose measurements at each SID setting for AP cranium radiographs are shown in the table above. setting SID 100 cm produces a radiation dose of 5.58 mSv, SID 110 cm produces a radiation dose of 5.16 mSv, SID 120 cm produces a radiation dose of 5.02 mSv, SID 130 cm produces a radiation dose of 4.84 mSv, SID 140 cm produces a radiation dose of 4.64 mSv and SID 150 cm produces a radiation dose of 4.36 mSv. There are differences in radiation dose values between SID settings of 100 cm, 110 cm, 120 cm, 130 cm, 140 cm and 150 cm with a statistical test p-value 0.001. The results of statistical tests on the Contrast to Noise Ratio value on changes in the SID value of the AP cranium radiography examination showed no significant difference. The p-value of the statistical test is 0.274 which means there is no difference in the CNR value between the SID settings of 100 cm, 110 cm, 120 cm, 130 cm, 140 cm and 150 cm.Conclusions: An increase in SID causes a decrease in radiation dose. The increase in SID did not cause a significant difference to the quality of the Contrast to Noise Ratio on the AP cranium radiograph image.

PERANAN PROYEKSI STITCH VIEW LONG LEG PADA PEMERIKSAAN KNEE JOINT DENGAN INDIKASI OSTEOARTHRITIS Purwa Puspita Arum; Panji Wibowo Nurcahyo
JRI (Jurnal Radiografer Indonesia) Vol. 4 No. 2 (2021)
Publisher : Perhimpunan Radiografer Indonesia (PARI)

ABSTRACT Introduction: Long Leg View is an x-ray examination of all parts of the lower extremity using a long vertical cassette which aims to measure the angle between the mechanical axis of the femur and tibia. Knee Joint examination with indications of osteoarthritis at the Radiology Installation of RSUP Dr. Sardjito Yogyakarta uses supine AP projection, Lateral recumbent, Skyline, and Stitch View Long Leg. Methods: This research is a qualitative research with a case study approach. Collecting data by means of observation, documentation, and in-depth interviews with patients, sending doctors, radiologists, and radiographers. Data collection was carried out in March 2018 at the Radiology Installation of Dr. RSUP. Sardjito Yogyakarta. The data obtained were analyzed using an interactive model. Results: On the Stitch View Long Leg examination at the Radiology Installation, Dr. Sardjito Yogyakarta uses a collimation area from the pelvis to the ankle joint. According to the resident doctor of orthopedic surgery and traumatology, Dr. Sardjito Yogyakarta, Stitch View Long Leg is able to see the shape of the foot formation, namely the O formation or X formation. In addition, according to radiology specialists, looking at the alignment deviation of the lower extremities can be used to assess the grade of osteoarthritis. Under normal conditions, the anatomical axis of the femur and tibia forms an angle of 6º ± 2º, while the mechanical axis line under normal conditions is 8 mm ± 7 mm medial to the center of the knee joint line. The alignment of varus and valgus has been associated with the development of medial or lateral osteoarthritis. Conclusion: Stitch View Long Leg aims to assess the grade of osteoarthritis through assessment of lower extremity alignment deviations, see the overall mechanical and anatomical alignment of the lower extremities, help determine the calculation of the angle of bone cutting during Total Knee Replacement surgery, and see the right and left symmetrical balance of genu.

INFORMASI DIAGNOSTIK GAMBARAN RADIOGRAF CERVICAL HASIL MULTIPLANAR RECONSTRUCTION CT-SCAN KEPALA Panji Wibowo Nurcahyo; Merliana Devina; Akhmad Haris Sulistiyadi; Siti Daryati
JRI (Jurnal Radiografer Indonesia) Vol. 4 No. 2 (2021)
Publisher : Perhimpunan Radiografer Indonesia (PARI)

ABSTRACT Introduction : Data at Kenyatta National Hospital (KNH) from 2012 to 2016 recorded that there were 1,432 patients with a head injury diagnosis. Of the patients diagnosed with moderate or severe head injury, 11 (3.07%) patients had head and neck injuries. The clinical pathway in the diagnosis of head injury, CT-Scan of the brain (preferably with the inclusion of the cervical vertebrae) is now the rule in assessing traumatic brain injury. At the Radiology Installation of the Salatiga City Hospital, a head CT scan with a head injury diagnosis used a scan of the area from cervical 7 to the vertex, then cervical radiographs were made using MPR. Methods : This study uses a qualitative method with a case study approach. Data collection was carried out in March 2020 by direct observation, in-depth interviews, and documentation studies.Results : Patients diagnosed with CKS and CKB were shown cervical MPR. This MPR image has no superposition, which usually shows cervical 1 and 2 superposition with the mandible even at an angle, and in the lateral projection, cervical 7 superposition with the shoulder. The disadvantage is that the radiation dose received by the patient increases, but on radiological examination there is a justification principle, namely even though using a CT-Scan with greater radiation, the benefits obtained are also greater. In addition, burst fractures can be seen on cervical radiographs from MPR. There are fractures in trauma victims that are not fully demonstrated on radiographs at cervical 1 to cervical 2, cervical 6 to 7 cervical levels, and most involve the transverse process because the patient is uncooperative. Helical CT scanning can depict significant fractures that cannot be demonstrated on conventional radiographs and should be added to the initial screening for suspected cervical trauma.Conclusion : The cervical MPR image aims to obtain four cervical projections, namely AP, lateral, right oblique, and left oblique without conventional projections with the aim of minimizing movement in patients who are at risk of aggravating spinal cord injury. Diagnostic information from MPR results is to obtain structural visualization. specific, determine the extent of the lesion, localize the lesion and bone fragments. However, the radiation dose received is greater than conventional radiographic examinations.

Verifikasi Geometri Kanker Nasofaring dengan Epid pada Pesawat Linac di Unit Radioterapi Instalasi Radiologi RSUP Dr. Kariadi Semarang Ardi Soesilo Wibowo; Wiratno Wiratno; Bagus Abimanyu; Panji Wibowo Nurcahyo
Jurnal Imejing Diagnostik (JImeD) Vol 7, No 1: JANUARY 2021
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v7i1.6592

Background: In Indonesia, nasopharyngeal cancer ranks 4th most in malignancies. As a method of treatment, the development of radiotherapy has made it possible to give high doses to tumors with little risk of healthy tissue, but still maintain accuracy by performing geometry verification procedures. The purpose of this study was to determine the geometry verification procedure of nasopharyngeal cancer with EPID on the Linac plane in RSUP Dr. Kariadi Semarang; the average geometric shift that occurs and why is only done before fractions 1 and 4 only.Methods: This type of research is qualitative with a case study approach. The data is taken from February 2019 to June 2019 by the method of observation, documentation and interviews. The data obtained were analyzed by interactive models, making transcripts of interviews then reduced and processed in the form of open coding, presented in the form of quotations and concluded.Results: The results showed that the geometry verification procedure was started by making a calendar treatment, adjusting the patient's setup at the origin point, switching to the iso center point. Take the image portal with EPID AP and Lateral projections. Match image portals with DRR images. Then the geometric shift data were obtained with a mean shift from the iso center in 5 patient samples: vertical axis 0.15 cm to superior; longitudinal -0.01 cm anteriorly and laterally 0.04 cm to the right. Tolerance limit of 0.3 cm. This verification is only done before fractions 1 and 4 because of the high service load.Conclusion: The geometry verification procedure has been going well with the results of the shift is still below the tolerance limit. Verification information before the 1st and 4th fractions was not enough to assess the accuracy of the irradiation carried out properly maintained.

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