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Informasi Anatomi Radiograf Dengan Dan Tanpa Penyudutan Tabung Sinar-X Pada Pemeriksaan Pedis Proyeksi AP Ardi Soesilo Wibowo; Kholik Al Amin; Panji Wibowo Nurcahyo; Ahmad Haris Sulistiyadi; Asri Indah Aryani
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.v7i2.7477

Background: On radiographic examination, the direction of the beam affects the anatomical image of the object produced. Pedis examination of the AP projection is a radiographic examination that uses two directions of beam. The direction of beam is with and withhout X-ray tube angulation. This research aims to compare radiograph anatomy information with and without X-ray tube angulation on pedis examination of the ap projection.Methods: This type of research is qualitative research with a descriptive approach. Data was obtained by making radiographs using with and without X-ray tube angulation using object phantom. The radiographic imaging of the pedis were observed by ten respondents, consist of radiology specialist t and resident radiology specialist, by giving questionnaires. Then the data obtained will be processed by being described and analyzed.Results: The result of the research showed different of x-ray tube angulation on the pedis examination on AP projections is the use of 100 angles because they get a high score. As well as the use of angle 100 chepalad can visualize both the interphalangeal joint space, metatarsophalangeal joint space, tarsometatarsasl joint space, joint space between the navicular and cuneifrome appear open, navicular, and cuboid. While the use of an angle of 00 can show the sesamoid bone and three cuneiform bones quite well. The angle of the beam direction is 100 chepalad so that the direction of the beam is perpendicular to the metatarsal bone so that there is no distortion in the metatarsal bone image. If the case is a fracture without having to prioritize the joint space, then the examination without an angle can be done because it is easier and saves time.Conclusion: AP projection of the pedis radiograph with the use of an angle 100 chepalad and without the use of posterior tube angulation with the posterior beam toward the heel produces different anatomical information. The most optimal anatomical information is generated by the use of a 100 chepalad.

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.

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.

KUALITAS FOTO POLOS PASIEN DENGAN DAN TANPA LAVEMENT Panji Wibowo Nurcahyo
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.v5i2.128

ABSTRACT Introduction: Patient preparation aims to minimize the appearance of air and feces which can interfere with doctors assessing anatomy and pathology on radiographs, and in some cases can even cause a delay in IVP examination. The results showed that there was no statistically significant difference between KUB examination patients with and without patient preparation (Abbasi A, Siyal A and Soomro M.I, 2015). Preparation of IVP patients between outpatients and inpatients at Prof. Hospital. Dr. Margono Soekardjo Purwokerto differs in the presence or absence of lavement. Method: This type of research is descriptive research. The population of the study was request sheets for photos and plain photo radiographs for BNO IVP examination with indications of hydronephrosis. The exclusion criteria for this study were patients aged ≥ 50 years to avoid the effects of constipation. The assessment uses a questionnaire that refers to The European Commission Guideline For Evaluation Of Radiographic Images and the assessment criteria determined by the researcher. Results: up to 6 patients came from the Inpatient Installation and 6 patients came from the Outpatient Installation. Inpatient installation has a higher total score for renal outline. Inpatient installation has a lower total score for visualization of the right psoas line and bone system, but gives the same score for the left psoas line. The Inpatient Installation has a higher total score for visualizing a lot of air and feces than the Outpatient Installation for the proximal colon area, while the distal colon area has the same score. In the distal colonic area, more radiographs from inpatient settings show air and stool features that may interfere with diagnosis than outpatient settings. This can be caused by visits from guests when visiting patients. The tendency of guests to bring food and chat with patients can affect this. Conclusion: In general, radiographs from outpatients and inpatients can clearly show the organs which include, the entire urinary tract area from the upper pole of the kidney to the basal bladder, renal outline, psoas line and bone system, but visualization of a lot of air and feces is more higher than the Outpatient Installation for the proximal colon area, while the distal colon area has the same score.

PROSEDUR PEMERIKSAAN RADIOGRAFI HIP JOINT POST-OPERASI TOTAL HIP ARTHOPLASTY Wildan Hanayzul Fahmi; Panji Wibowo Nurcahyo
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.v5i2.130

ABSTRACT Background: Conventional radiographic examination of the hip joint post-operative Total Hip Arthoplasty aims to propose a prosthesis on the Hip Joint. Parameters assessed with AP Pelvis Projection include leg length, center of horizontal rotation, center of vertical rotation. Acetabular inclination, femoral stem positioning, and cement mentle thickness can be assessed on AP Unilateral Hip Projection and AP Pelvis Projection, whereas Acetabular anteversion can only be seen with inferosuperior axiolateral projections. Conventional radiographic examination of the hip joint after Total Hip Arthoplasty surgery at the Radiology Installation of Tidar Magelang Hospital was only carried out by AP Pelvis Projection. Method: This research type is qualitative with case study approach. Data collection methods consisted triangulation method of observation, interview and documentation. Research subject consist 3 radiology technologist, 1 specialist doctor, and 1 radiology doctor. Collected data will be analyzed with interactive technique transformed into transcript and then reducted. After that the data will be shown as quotation. Based on data and literature study, author will conclude. Result: Radiographic exam of hip joint post-operation Total Hip Arthoplasty in Radiology Departement of RSUD Tidar Magelang is done in accordance to standard procedure of only using AP Pelvic projection. This is done to acquire radiographic image of both sides of the hip joints, the whole prosthetic component, and reducing the radiation received. Central point set on the center of symphisis pubic, with area of collimation as wide as the detector to acquire image of the whole prosthetic. Without lateral projection the lateral view of the prosthetic cannot be acquired causing the absence of the radiographic images of both acetabular anteversion and the acetabular retroversion. Causing the angle of acetabular component of the prosthetic cannot be measured. Resulting in the loss additional information. Conclusion: AP Pelvic projection is in accordance to standard procedure of Radiology Departement of RSUD Tidar Magelang, specialist doctor’s request, and had shown the radiographic image of the whole prosthetic component. From author’s opinion, it is best that lateral projection still be done to acquire complete information of the radiographic evaluation of post-operation Total Hip Arthoplasty.

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.

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