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Wahyu Setia Budi
Department Of Physics, Faculty Of Science And Mathematics, Diponegoro University
Arts Astronomy Chemical Engineering, Chemistry & Bioengineering Civil Engineering, Building, Construction & Architecture Computer Science & IT Earth & Planetary Sciences Education Electrical & Electronics Engineering Energy Engineering Environmental Science Health Professions Materials Science & Nanotechnology Mathematics Medicine & Pharmacology Physics Public Health Social Sciences Other

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Journal : MEDIA MEDIKA INDONESIANA

 1 
Uji Diagnostik Pemeriksaan Tulang Osteolitik Berbasis Intensitas Citra Digital Susilo Susilo; Maesadji Tjokro Nagoro; Kusminarto Kusminarto; Wahyu Setia Budi
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 1 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

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Abstract

Diagnostic test of osteolytic bone examination based on digital image intensityBackground: The visual examination of bone radiographs using digital computed radiography (CR) is an examination for the diagnosis of bone-metastatic cancer. The subjectivity of interpretation of bone radiographs may lead to doctor’s doubt in making decision to treatment patients with bone-metastatic cancer. Software Matlab-based computer application program makes a standard method to organize the results of bone radiographs. The objective of this study is to develop a software based on Matlab to analyze the diagnostic values, and to determine the optimal of cut off point to diagnose of osteolytic bone.Method: The researches data are collected from Department of Radiology of three hospitals i.e. Dr. Kariadi Hospital Semarang, Dr. Sardjito Hospital and Bethesda Hospital Yogyakarta. This research was carried out during four month from April to August 2009. Radiographs of osteolytic bone interpreted by radiologist were compared with PA examination result of the osteolytic bone which were viewed as the gold standard. The steps in this study i.e. patients are classified as a normal or osteolytic bone patients based on the cut off point that had been determined, calculate the value of the diagnostic test using 2x2 tables, determined the area under the curve (AUC) by the procedure of receiver operating characteristic (ROC), and determined the optimal of cut off point.Result: The results of study show that the diagnostic test for osteolytic bone by using Matlab-based software has sensitivity of 0.88, specificity of 0.891, positive expected value of 0.897, negative expected value of 0.950 and the cut off point at 0.93, while, the value of area under the curve (AUC) is 94% (95% CI: 89.7%-98.3%), and the accuracy is 0.881 for the case of osteolytic bone.Conclusion: Matlab-based software being used for diagnosing osteolytic bone has relatively high sensitivity and specificity.Keywords: Digital image, bone metastases, osteolytic, optimum cut off point ABSTRAKLatar belakang: Pemeriksaan radiograf tulang secara visual menggunakan sistem radiografi digital CR (computed radiography) merupakan pemeriksaan untuk diagnosis kanker metastasis tulang. Subyektivitas interpretasi radiograf tulang dapat menyebabkan keraguan dokter dalam mengambil keputusan untuk pengobatan pasien dengan kanker tulang metastatik. Software berbasis program aplikasi computer Matlab membuat suatu metode standard untuk mengorganisasikan hasil radiograf tulang. Tujuan penelitianadalah mengembangkan software berbasis Matlab untuk menganalisis nilai-nilai diagnostik, cut off point optimal dan akurasi pemeriksaan pada diagnosis tulang osteolitik.Metode: Data penelitian diambil di bagian radiologi dari tiga rumah sakit, yaitu RSUP Dr. Kariadi Semarang, RSUP Dr. Sardjito dan Rumah Sakit Bethesda Yogyakarta. Penelitian dilakukan selama empat bulan dari April sampai Agustus 2009. Radiograf tulang  osteolitik yang diinterpretasikan oleh radiolog ini dibandingkan dengan hasil pemeriksaan PA tulang osteolitik yang dianggap sebagai gold standard. Langkah yang dilakukan dalam penelitian ini adalah pasien diklasifikasikan sebagai pasien tulang normal dan pasien osteolitik berdasar cut off point yang telah ditetapkan, menghitung nilai uji diagnostik menggunakan tabel 2x2, menghitung luasan di bawah kurva (AUC) dengan cara receiver operating characteristic (ROC), serta menetapkan cut off point optimal.Hasil: Hasil penelitian menunjukkan bahwa uji diagnostik tulang osteolitik menggunakan software berbasis Matlab memiliki sensitivitas 0,875, spesifisitas 0,891, nilai dugapositif 0,897, nilai duga negatif 0,950 dan cut off point 0,93. Nilai luasan di bawah kurva (AUC) ROC adalah sebesar 94%
Uji Diagnostik Pemeriksaan Osteosklerotik Tulang dengan Sistem Radiografi Digital Susilo Susilo; Maesadji Tjokro Nagoro; Kusminarto Kusminarto; Wahyu Setia Budi
MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 3 Year 2011
Publisher : MEDIA MEDIKA INDONESIANA

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Abstract

ABSTRACTDiagnostic test of bone osteosclerotics examination using digital radiography systemBackground: The interpretation of a conventional röntgen images have a high degree of subjectivity due to the limitation of humansight. The computationally detection help establish the accuracy of diagnosis of the radiologist. According to our knowledge, there has not been previous research on this issue in Indonesia. The research was aimed to examine a Matlab based software to determine the diagnostic value in the diagnosis of osteosclerotic bone.Methods: This study was a diagnostic test which was conducted in Radiology Department of Dr. Kariadi Hospital Semarang, Dr.Sardjito Hospital Yogyakarta and Bethesda Hospital Yogyakarta, April to August 2009. The radiographs of bone osteosclerotic resulted from computed radiography (CR) test results were taken consecutively, interpreted by a radiologist which was supported by the Anatomical Pathology Laboratory examination as a gold standard. Afterwards these steps were done respectively: classify patients as a normal or osteosclerotic patients based on the cut off point that was determined, calculate the value of the diagnostic by analysis of 2x2 tables, determine the area under the curve (AUC) by the procedure of receiver operating characteristic (ROC), anddetermine the optimal of COP (cut off point) using ROC procedure.Results: From the results of diagnostic tests of bone radiographs these following parameter values was obtained: AUC value of 97.6% (95% CI: 94.4%-100%), the optimal cut off point for bone oseosclerotic COP ≥1.05 with a sensitivity value of 93.0% and a specificity of 89.1%. Suitability kappa value of 0.818 K (95% CI: 0.757 to 0.879).Conclusion: The radiographic examination of the results of CR using Matlab-based software can be used to diagnose boneosteosclerotic with high sensitivity and specificity.Keywords: Bone osteosclerotic, röntgen images, optimal of COP, Matlab softwareABSTRAKLatar belakang: Pembacaan foto röntgen secara konvensional memiliki tingkat subyektivitas tinggi karena keterbatasan indrapenglihatan manusia. Pendeteksian secara terkomputasi membantu menegakkan diagnosis para radiolog. Sebagaimana diketahui, belum ada penelitian sebelumnya mengenai masalah ini di Indonesia. Penelitian ini bertujuan menguji perangkat lunak berbasis Matlab untuk menentukan nilai diagnostik pada diagnosis tulang osteosklerotik.Metode: Penelitian ini adalah uji diagnostik yang dilakukan di Bagian Radiologi RSUP Dr. Kariadi Semarang, RSUP Dr. SardjitoYogyakarta dan Rumah Sakit Bethesda Yogyakarta, April-Agustus 2009. Radiograf osteosklerotik tulang hasil pemeriksaan CR (computed radiography) diambil untuk sampel secara konsekutif, kemudian diperiksa oleh radiolog yang didukung oleh pemeriksaan Laboratorium Patologi Anatomi sebagai baku emas. Tahapan yang dilakukan berturut-turut adalah: mengelompokkan pasien sebagai osteosklerotik dan normal berdasar titik potong yang ditentukan, menghitung nilai diagnostik dengan tabel analisis 2x2, menentukan AUC (area under the curve) dengan prosedur ROC (receiver operating characteristic), dan menentukan COP (cut off point) optimal dengan prosedur ROC.Hasil: Hasil uji diagnostik radiograf tulang diperoleh nilai-nilai parameter sebagai berikut: nilai AUC adalah sebesar 97,6% (IK 95%: 94,4%-100%), titik potong optimal untuk osteosklerotik tulang COP ≥1,05 dengan nilai sensitivitas sebesar 93,0% dan spesifisitas sebesar 89,1%. Nilai kesesuaian kappa K sebesar 0,818 (IK 95%: 0,757-0,879).Simpulan: Pemeriksaan radiografi hasil CR menggunakanperangkat lunak berbasis Matlab dapat digunakan untukmendiagnosis osteosklerotik tulang dengan sensitivitas danspesifisitas tinggi
Co-Authors Ade Ika Susan Afgani, Jundi Jundullah Agung Dwiyanto Ahmad Mutohar Ainul Ibnu Khotob Alan Tanjung Aji Prastowo Alfian Rizani Ali Khumaeni Anis Nila Kusuma Anugrah Ariyani S. Arif Fahmi Arifah, Dwi Intan Asep Yoyo Wardaya Astrihasna Shafa Bambang Haris Suhartono, Bambang Haris Choirul Anam Choirul Anam AM Diponegoro Chorirul Anam Dewandaru, Ardian Dewantoro, Fajar Dewantoro, Fajar Dhahryan Dhahryan Dini Desita Dwi Siwi Retnoningsih Eddy Prianto Eko Hidayanto Erni Setyowati Fadil Nazir Fajar Arianto Fatkhiyatul Athiqoh G. B. Suparta Gagoek Hardiman Gagoek Hardiman Gani Gunawan Gani Gunawan Hamdani, Muhammad Alif Iza Handayani, Liska Tri Harianja, Bernard Hendrika Liana Sari Heri Sugito Heri Sutanto Hidayatullah, Aydymas Davansyah I Wayan Ari Makmur Ismail Ismail Istifadatun Ni’amah Juhroh, Aminatul Jundi Jundullah Afgani K Sofjan Firdausi K. Sofjan Firdausi Kaka, Susanti Radi Kesawa Sudarsih Ketut Sofjan Firdausi, Ketut Sofjan Khomilia, Crysant Ayu Sufi Kusminarto Kusminarto Kusminarto Kusminarto Kusminarto Kusminarto Kusworo Adi Liska Tri Handayani Maesadji Tjokro Nagoro Maesadji Tjokro Nagoro Maliki Maliki Maria Carizza Pandora Raharjo Masrokan Masrokan Masrokan, Masrokan Michelson Fahrurazi Much Azam Muhamad Adi Muharam Budi Laksono, Muharam Budi Nora Fajria Nur Dwi Prasetyo Pandora Raharjo, Maria Carizza Prasetyo Basuki Pratama, Arthana Setia Priyono, Setyo Purwanto Purwanto Rahmawati, Fatimah Dwi Rini Shintawati Rozanah Rozanah Rusmaharani, Diyah Sihotang, Pandapotan Sugiarto, Oki Suhardi Suhardi Sunarsih Sunarsih Supriyati Supriyati Suryono Suryono Susanti, Audry Nadifa Susila Wardaya, Susila Susilo Susilo Susilo Susilo Susilo Susilo Sutiah Sutiah Sutiyowati Sutiyowati, Sutiyowati Sutrati Melissa Malik Syamsiar, Syamsiar Taqwim S, M Ainut Titi Purwati Tri Wulan Tjiptono Tri Wulan Tjiptono Very Richardina Vitria, Yati Weirna Yusanti Wibowo, Danang Rujito Widiastuti, Ratih Wulandhari Wulandhari Zaenal Arifin