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All Journal Jurnal Sain Veteriner Buletin Peternakan Jurnal Sains dan Teknologi Nuklir Indonesia (Indonesian Journal of Nuclear Science and Technology) Majalah Kedokteran Bandung Althea Medical Journal Jurnal Kedokteran Jurnal Keselamatan Radiasi dan Lingkungan Sari Pediatri Journal of Medicine and Health BENTANG : Jurnal Teoritis dan Terapan Bidang Rekayasa Sipil Jurnal Ilmu Kefarmasian Indonesia Bioscientia Medicina : Journal of Biomedicine and Translational Research Medika Kartika : Jurnal Kedokteran dan Kesehatan Bioscientia Medicina : Journal of Biomedicine and Translational Research Bandung Conference Series : Medical Science Jurnal Sains dan Teknologi Farmasi Indonesia Deka in Medicine Journal of Medicine and Health
Basuki Hidayat
Fakultas Kedokteran, Universitas Padjadjaran
Humanities Biochemistry, Genetics & Molecular Biology Chemistry Civil Engineering, Building, Construction & Architecture Dentistry Energy Environmental Science Health Professions Immunology & microbiology Materials Science & Nanotechnology Mechanical Engineering Medicine & Pharmacology Neuroscience Nursing Physics Public Health Transportation Veterinary Other

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Studi Dosimetri Internal Radiofarmaka Terapi Kanker Payudara 177Lu-DOTA-Trastuzumab Susyati Susyati; Abdul Mutalib; Muchtaridi Muchtaridi; Martalena Ramli; Sri Aguswarini; Karyadi Karyadi; Basuki Hidayat; Stepanus Massora
Jurnal Keselamatan Radiasi dan Lingkungan Vol 1, No 1 (2016): Juni 2016
Publisher : Pusat Teknologi Keselamatan dan Metrologi Radisasi - BATAN

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Abstract

Pengobatan terarah berbasis imunologik (Imunoterapi) kanker payudara dengan mekanisme pengikatan reseptor HER2/neu oleh antibodi spesifik telah dikembangkan oleh para peneliti sejak tahun 80-an. Trastuzumab adalah antibodi yang pertama disetujui oleh Badan Pengawas Obat dan Makanan Amerika. Dari pemantauan diketahui bahwa pengobatan dengan trastuzumab selain berbiaya tinggi juga terjadi kardiotoksisitas dan resistensi obat. Mengantisipasi hal ini, para peneliti mulai mengembangkan trastuzumab dalam bentuk konjugat dengan suatu radionuklida (salah satunya adalah 177Lutesium), sebagai farmaka Radioimunoterapi (RIT) baru. Sebagai penerapan aspek keselamatan untuk tujuan melakukan proteksi terhadap pasien dari efek samping pemberian dosis radiasi internal yang tidak akurat, studi dosimetri internal perlu dilakukan sejak awal pengembangan farmaka RIT baru. Tujuan studi dosimetri internal pada RIT adalah memastikan pemberian dosis radiasi internal yang akurat dan aman untuk setiap individu pasien/memaksimalkan dosis radiasi ke sel-sel kanker dan meminimalkan dosis radiasi ke sel-sel normal. Radiofarmaka baru (177Lu)m-(DOTA)n-trastuzumab telah berhasil dipreparasi oleh para peneliti BATAN. Uji praklinik in vivo/uji biokinetik pada hewan coba mencit betina normal inbred substrain BALB/c paska pemberian dosis tunggal 100 µCi bolus intravena injeksi radiofarmaka 177Lu-DOTA-trastuzumab juga telah dilakukan. Ruang lingkup studi dosimetri internal yang dilakukan ini adalah melakukan penghitungan perkiraan dosis terabsorb oleh berbagai organ hewan coba berdasarkan data biokinetik hasil uji praklinik in vivo. Dari hasil penghitungan perkiraan dosis terabsorb menggunakan persamaan MIRD dengan bantuan data Fraksi absorbsi spesifik dari pustaka diketahui bahwa dosis terabsorb organ paru-paru paling tinggi diantara organ-organ lainnya, yaitu 1,5X10-2 µGy. Dengan memperhitungkan faktor bobot tipe radiasi dan faktor bobot tipe jaringan/organ (sebagaimana tercantum pada Publikasi ICRP No.103 tahun 2007), diperoleh dosis ekivalen dan dosis efektif organ paru-paru berturut-turut adalah 1,5 X 10-2 µSv dan 1,8 X 10-3 µSv. Dosis efektif seluruh tubuh hewan coba adalah 4,2 X 10-3 µSv. Data biokinetik berbagai organ hewan coba dapat juga dipakai sebagai masukan (input) pada penghitungan perkiraan dosis terabsorb berbagai organ phantom manusia menggunakan software dosimetri internal tertentu, seperti OLINDA/EXM software. Breast cancer targeted therapy which mechanism is the binding of HER2/neu receptor with specific antibodies have been developed by researchers since the 80’s. Trastuzumab is the first antibody approved by the US Food & Drug Administration. From monitoring known that treatment with trastuzumab also occur cardiotoxity and drug resistance in addition to high costs. Anticipating this, the researchers began developing trastuzumab in the conjugate form with a radionuclide (one of which is 177Lutesium) as a new pharmaceutical of Radioimmunotherapy (RIT). As the implementation of safety aspects in order to protect the patients from adverse effects of inaccurate internal radiation dose administration, internal dosimetry studies / assessment need to be done since the beginning of a new RIT pharmaceutical development. The objective of internal dosimetry study at RIT is to ensure accurate and safe internal radiation dose administration for each individual patients / to maximize the radiation dose to the cancer cells and minimize the radiation dose to the normal cells. The new RIT pharmaceutical 177Lu-DOTA-trastuzumab has been successfully prepared by BATAN researchers.  In vivo preclinical trials/biokinetic testing in normal female mice inbred substrain BALB/c after administration of a single dose 100 μCi of bolus intravenous 177Lu-DOTA-trastuzumab radiopharmaceutical injection also been conducted. The scope of internal dosimetry studies conducted was absorbed dose calculation estimation of the various experimental animals organs based on biokinetic data of in vivo preclinical trials. Calculation estimation of Absorbed Dose using the MIRD (Medical Internal Radiation Dose) equation with the aid of SAFs (Specific absorbed fractions) data from reference known that Absorbed Dose of lungs organ is highest among other organs ie. 1,5 X 10-2µGy. Taking into account of recommended radiation weighting factors and tissue / organ weighting factors (as stated in ICRP Publication #103, 2007) obtained equivalent dose and effective dose of lungs organ is 1,5 X 10-2 μSv and 1,8 X 10-3μSv respectively. The whole body effective dose of experimental animal is 4,2 X 10-3 μSv. The biokinetic-test results data of the various experimental animal organs can also be used as an input on the Absorbed dose calculation estimation of the various human phantom organs using certain internal dosimetry software (one example is OLINDA/EXM software).
Gambaran Pertumbuhan Anak dengan Hipotiroid Kongenital Pasca-Terapi Levotiroksin di RSUP Dr. Hasan Sadikin pada Tahun 2014 sampai dengan 2018 Noviola Ruth Adisty; Faisal Faisal; Basuki Hidayat
Sari Pediatri Vol 22, No 2 (2020)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp22.2.2020.98-103

Abstract

Pendahuluan. Hipotiroid kongenital merupakan penyebab gangguan tumbuh kembang anak yang dapat dicegah dengan terapi levotiroksin dini. Akan tetapi di Indonesia, diagnosis dini berdasarkan skrining hipotiroid kongenital cakupannya rendah sehingga banyak kasus mengalami gangguan pertumbuhan akibat keterlambatan terapi.Tujuan. Mengetahui gambaran pertumbuhan anak dengan hipotiroid kongenital pasca-terapi levotiroksin.Metode. Penelitian retrospektif potong lintang menggunakan data rekam medis pasien anak dengan hipotiroid kongenital selama kurun waktu 2014-2018 di Poli Anak RSUP Dr. Hasan Sadikin. Pertumbuhan dipantau berdasarkan laju pertumbuhan linear dan indeks antropometri kurva pertumbuhan WHO 2005.Hasil. Sejumlah 51 pasien memenuhi kriteria, mayoritas subjek didiagnosis hipotiroid kongenital pada usia 0-12 bulan (78,4%), berjenis kelamin laki-laki (60,8%), dan memiliki komorbiditas (66,7%). Rerata laju pertumbuhan linear berdasarkan kelompok usia 0-12 bulan (n=40), 1-2 tahun (n=3), 2-5 tahun (n=1) dan >5 tahun (n=7), berturut-turut 21,77,3 cm/tahun, 10,23,8 cm/tahun, 8,6 cm/tahun, dan 13,55,2 cm/tahun. Komorbiditas tidak ditemukan pada subjek usia 2-5 dan >5 tahun. Pasca-terapi, 9 subjek dengan perawakan sangat pendek/pendek pre-terapi menjadi berperawakan normal, 8/9 subjek usia 0-12 bulan dan sisanya >5 tahun, serta semuanya tidak memiliki komorbiditas.Kesimpulan. Pertumbuhan anak mengalami perbaikan pasca-terapi levotiroksin berdasarkan laju pertumbuhan linear dan indeks antropometri terutama pada anak yang diterapi dini dan tanpa komorbiditas.
Generalized Lymphadenopathy due to Chronic Lymphocytic Leukemia (CLL) : 18F-FDG PET Imaging Basuki Hidayat; Febby Hutomo; Ryan Yudistiro; Ivana D. Mulyanto; Hendra Budiawan; Johan S. Masjhur
Journal of Medicine and Health Vol. 1 No. 3 (2016)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (222.033 KB) | DOI: 10.28932/jmh.v1i3.520

Abstract

Lymphadenopaty is a common clinical finding with a broad differential diagnosis, withCarcinoma of Unknown Primary (CUP) as one of it’s most common causes. Flourine-18 fluoro-2 deoxy glucose (18F- FDG) positron emission tomography (PET) is a Nuclear Medicinescintigraphy procedure commonly used to localize suspected a primary lesion by depicting ametabolic status. However, in the expertise of 18F FDG PET study, clinical finding andepidemiologic data must be considered to get a better conclusion. We describe 18F-FDG PETstudy in the presence of generalized lymphadenopathy due to chronic lymphocytic leukemia(CLL), a rare disease which is initially suspected of having CUP.Keywords: 18F-FDG PET, lymphadenopathy, lymphoma, leukemia
Uji Preklinis 177Lu-DOTA-Trastuzumab: Radiofarmaseutika Potensial untuk Terapi Kanker Payudara HER-2 Positif MARTALENA RAMLI; BASUKI HIDAYAT; SRI AGUSWARINI; KARYADI KARYADI; CAHYA NOVA ARDIYATNO; HAMMAD SUBUR; TITIS SEKAR HUMANI; RIEN RITAWIDYA; ABDUL MUTALIB; JOHAN MASJHUR
JURNAL ILMU KEFARMASIAN INDONESIA Vol 11 No 2 (2013): JIFI
Publisher : Fakultas Farmasi Universitas Pancasila

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Abstract

Radiopharmaceutical 177Lu-(1,4,7,10-tetraazacyclododecane-N,N’,N”,N”’-tetra acetic acid)-trastuzumab (177Lu-DOTA-trastuzumab), based on antihuman epithelial receptor type 2 (HER-2) monoclonal antibody which is expected to be potential for diagnostic and therapeutic agent of breast cancer positive HER-2, had been successfully prepared with radiochemical purity of > 99%. Preclinical studies aimed in providing basic data for clinical trial and particularly in finding out the effectiveness of 177Lu-DOTA-trastuzumab in killing cancer cells which over express HER-2, have been performed. The data included urine and faeces clearance tests, imaging with gamma camera and cytotoxicity test. The results showed that the excretion of radioactivity post injection of 177Lu-DOTA-trastuzumab in normal rats were more rapid through urine as compared to the excretion through faeces. The gamma camera image on normal rat 144 hours post injection of 177Lu-DOTA-trastuzumab showed that there was remaining a trace of radioactivity in hepatic area. The residue of radioactivity (< 5%, quantified by biodistribution test) was found to be relatively lower than reported for 111In-NSL-trastuzumab. However, this residue of radioactivity has to be seriously considered when 177Lu-DOTA-trastuzumab is going to be applied for treatment of cancer. Cytotoxicity test showed that 177Lu-DOTA-trastuzumab was far more effective in killing cancer cells positive HER-2 (SKOV-3 cell lines) than that of trastuzumab.
Metoda Penyiapan Konjugat (DOTA)n-[Dendrimer PAMAM]-(Trastuzumab)m Sebagai Bahan Radiofarmaka Radioimunoterapi (177Lu-DOTA)n-[Dendrimer PAMAM]- (Trastuzumab)m RIEN RITAWIDYA; SRI SETYOWATI; CECEP TAUFIK RUSTENDI; MASKUR MASKUR; MARTALENA RAMLI; BASUKI HIDAYAT; MUHAMMAD SUBUR; ABDUL MUTALIB; JOHAN MASHYUR
JURNAL ILMU KEFARMASIAN INDONESIA Vol 12 No 2 (2014): JIFI
Publisher : Fakultas Farmasi Universitas Pancasila

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Abstract

Radioimmunotherapy is one of modalities means of treatment for cancer that exploits the antibody monoclonal specificity to bind to its receptor and the ability of alfa or beta radiation in destroying cancer cells. Trastuzumab is humanized IgG1 monoclonal antibodies which selectively bind to extracellular domain of Human Epidermal Growth Factor Receptor-2 (HER-2). HER-2 has now became a target receptor for treatment of human breast cancer due to their overexpression in the human breast cancer cell surface. This study was aimed in developing a method for preparation of (DOTA) n-[Dendrimer PAMAM]-(trastuzumabm conjugate, a precursor of (177Lu-DOTA)n-PAMAM-(trastuzumab) m radioimmunoconjugate, which is expected to be potential for breast cancer radioimmunotherapy. The conjugate was prepared through several conjugation steps. Characterization of (DOTA)n-[Dendrimer PAMAM]-(trastuzumab)m which was carried out by using a HPLC equipped size exclusion column (SEC) gave a clean peak with retention time (tR) of 10.53 mins which was slower compared to tR of its precursor unconjugated trastuzumab (10.70 mins). This result indicated that molecular weight of (DOTA)n-[Dendrimer PAMAM]-(trastuzumab)m was bigger than its precursor (unconjugated trastuzumab) and pure. The purity of (DOTA)n-[Dendrimer PAMAM]- (trastuzumab)m was verified by measuring the Rf of 177Lu-radiolabeled-(DOTA)n-[Dendrimer PAMAM]-(trastuzumab)m using instance thin layer chromatography-silica gel (ITLC-SG). The ITLC-SG of (DOTA)n-[Dendrimer PAMAM]-(trastuzumab)m which was radiolabeled with 177Lu- gave a clean peak with Rf of <0.3, while the precursors which were regards as impurities, (free 177Lu in form 177Lu-EDTA, 177Lu-DOTA, and 177Lu- dendrimer PAMAM which was incubated as non specific binding), all of them gave Rf of >0.6. These ITLC results indicated that (DOTA)n-[Dendrimer PAMAM]-(trastuzumab)m radiolabeled with 177Lu was pure.
Association Bone Schintigraphy with Prostate Spesific Antigen, Gleason score, and Grade group in Prostate Cancer Patient Reza Rinaldy Harahap; Achmad Hussein Sundawa Kartamihardja; Basuki Hidayat; Hendra Budiawan; Budi Darmawan; Raden Erwin Affandi Soeriadi Koesoemah
Unram Medical Journal Vol 10 No 4 (2021): Jurnal Kedokteran Volume 10 nomor 4 (Desember) 2021
Publisher : Faculty of Medicine Universitas Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jku.v10i4.620

Abstract

Background. Metastasis (especially in bone) in prostate cancer is often difficult to diagnose and poor prognosis. Hence, it is very important to do an early examination in detecting metastasis. Frequent bone scintigraphy indicators are prostate specific antigen (PSA) level and Gleason score (GS). This study aims to analyze how strong correlation of these factors in affecting bone metastasis in prostate cancer. Subject and method. A retrospective cross-sectional analysis study was performed using medical records of the prostate cancer patients who underwent Tc-99m MDP bone scintigraphy at Hasan Sadikin General Hospital during January 2012 until December 2016. PSA level, GS and Gleason grade (GG) data were analyzed by bivariate and multivariate analysis. Result. From 189 medical records, only 110 medical records were eligible to be analyzed. Bivariate analysis demonstrated statistically significant correlation for PSA level (p <0.001) and GS (p 0.05 and p 0.036) with bone metastasis in prostate cancer. Multivariate analysis showed that PSA remains the strongest factor associated with bone metastasis in prostate cancer (p 0.001). Conclusion. From bivariate analysis, serum PSA level have statistically significant correlation with bone metastasis in newly diagnosed prostate cancer patient. In the GS dan GG classification, the higher-grade of GS or GG the higher bone metastasis in prostate cancer patient. Thus, the above results may be helpful in identifying prostate cancer patients who have a high risk for bone metastasis.
LIMFOMA TULANG YANG MENYERUPAI METASTASIS KARSINOMA TIROID FOLIKULER: LAPORAN KASUS M Aulia Prima; Budi Darmawan; Basuki Hidayat; Erwin Affandi Soeriadi; Kharisma Perdani Kusumahstuti
Medika Kartika : Jurnal Kedokteran dan Kesehatan Vol 5 No 4 (2022): Medika Kartika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran Universitas Jenderal Achmad Yani

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Abstract

Karsinoma tiroid folikuler merupakan subtipe kedua tersering yang umumnya bermetastasis ke tulang. Beberapa teknik pencitraaan dapat digunakan untuk mendeteksi adanya metastasis. Kami melaporkan kasus suspek metastasis karsinoma tiroid yang kemudian dinyatakan sebagai limfoma tulang. Wanita berusia 33 tahun dirujuk mendapatkan terapi radiotiroablasi menggunakan NaI 131. Pasien mengeluh suara serak, kadang masih terasa nyeri pada luka bekas operasi di leher, dan terdapat benjolan pada dahi kanan terasa nyeri. Pasien diduga mengalami metastasis calvaria oleh pemeriksaan CTScan sebelumnya. Pasien dengan riwayat karsinoma tiroid folikuler pasca tiroidektomi total dan mendapatkan terapi Levotiroksin 1x200mcg. Hasil TSH 0,1 uIu/ml dan Tiroglobulin <0,06 ng/ml dalam keadaan tersupresi. Pasien diberikan terapi NaI 131 100 mCi, 48jam pasca terapi dilakukan pemeriksaan citra planar dan SPECT/CT sidik seluruh tubuh, dengan hasil tampak adanya sisa jaringan tiroid fungsional dan samar-samar gambaran metastasis calvaria. Kami memberi saran untuk pengangkatan massa tumor. Pasca operasi, penilaian histopatologi menunjukkan adanya NonHodgkin Lymphoma (NHL) pada tulang. Dibandingkan dengan hasil sidik seluruh tubuh dan CTScan didapatkan hasil yang berbeda mengenai adanya metastasis calvaria. Oleh karena itu, pasien kami sarankan untuk pemeriksaan 18FDG-PET/CT Onkologi. Sementara itu, kemoterapi dan radiasi eksternal direncanakan pada pasien. Kanker tiroid yang bersamaan dengan limfoma tulang sangat jarang. Saat ini biopsi masih menjadi baku emas untuk konfirmasi diagnosis, namun pencitraan kedokteran nuklir dapat dipertimbangkan sebagai salah satu pendekatan diagnosis untuk membedakan suatu keganasan merupakan metastasis dari tiroid atau bukan. 18F-FDG PET/CT dengan kemampuannya untuk mendeteksi metastasis yang tidak dapat menangkap radioiodine. Pendekatan manajemen pasien yang tepat dapat menurunkan mortalitas pasien dengan keganasan. Kata kunci: Karsinoma tiroid, limfoma tulang, metastasis DOI : 10.35990/mk.v5n4.p448-458
TEKNESIUM-99m METOKSI ISOBUTIL ISONITRIL (99mTc-MIBI) SEBAGAI SEDIAAN UJI TAPIS PENYAKIT JANTUNG KORONER PADA PENDERITA DIABETES MELLITUS Hanafiah - Wangsaatmadja; Budi - Darmawan; Basuki - Hidayat
JURNAL SAINS DAN TEKNOLOGI FARMASI INDONESIA Vol 1, No 2 (2012)
Publisher : Sekolah Tinggi Farmasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (499.494 KB) | DOI: 10.58327/jstfi.v1i2.20

Abstract

AbstrakTelah dilakukan proses difusi teknologi dan pemanfaatan sediaan radiofarmasi Teknesium-99m Metoksi Isobutil Isonitril (99mTc-MIBI) untuk deteksi penyakit jantung koroner (PJK) pada beberapa penderita kencing manis (Diabetes Mellitus, DM). Sediaan MIBI disiapkan dalam bentuk kit cair, terdiri dari dua formula terpisah dan disiapkan sebagai sediaan yang memenuhi persyaratan farmasetika. Evaluasi biologis dilakukan pada tikus putih untuk melihat rasio distribusi penimbunan sediaan di jantung terhadap organ sekitarnya, sedangkan uji tapis PJK pada beberapa penderita DM dilakukan dengan elektrokardiografi (EKG), dan sidik perfusi miokard (SPM) menggunakan Single Photon Emission Computed Tomography (SPECT) dengan 99mTc-MIBI. Dari 24 subjek penelitian, 17 orang (71%) data SPM mengindikasikan kelainan miokard dan 7 orang dalam kondisi normal, sedangkan dari data EKG hanya 2 orang (8%) yang kemungkinan terindikasi PJK, 21 orang normal, dan 1 orang meragukan (equi-vocal). Hasil penelitian menunjukkan bahwa SPM memberikan prospek sebagai moda uji tapis yang dapat diunggulkan untuk memperbaiki penatalaksanaan PJK, dan bisa dijadikan modalitas pendeteksi lebih dini, khususnya pada penderita DM. Kata Kunci : MIBI, Diabetes Mellitus, PJK, EKG, SPM. AbstractTechnology diffusion and the application of Technetium-99m Methoxy Isobutyl Isonitrile (99mTc-MIBI) for detection of coronary artery diseases (CAD) has been carried out in patients with diabetes mellitus (DM). MIBI was prepared in the form of liquid phase radiopharmaceutical kit, consisting of two separated formulas with the pharmaceutical requirements. Biological test was performed on rat to evaluate the accumulation of the radiopharmaceutical in heart compared with the surrounding organ, while the screening test of CAD on several diabetic patients has been carried out using electrocardiograph (ECG) and myocardial perfusion imaging (MPI) performed with Single Photon Emission Tomography (SPECT) using 99mTc-MIBI. From the 24 research subjects, the MPI data indicate 17 people (71%) showed myocardial defect and 7 people in normal conditions, while the ECG data indicate only two people (8%) showed abnormalities, 21 people in normal conditions, and one person stated still doubted (equi-vocal). The result showed that MPI is clearly emerging as a valuable/screening tool for improving management of coronary artery disease, and become an early detection modality, especially in patients with diabetes mellitus. Keywords : MIBI, Diabetes Mellitus, CAD, ECG, MPI.
Identifikasi Paparan Radiasi Antar Pekerja Radiasi Instalasi Kedokteran Nuklir pada Beberapa Rumah Sakit Periode 2018-2020 Adella Puspitasari; Herri S. Sastramihardja; Basuki Hidayat
Bandung Conference Series: Medical Science Vol. 3 No. 1 (2023): Bandung Conference Series: Medical Science
Publisher : UNISBA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29313/bcsms.v3i1.6578

Abstract

Abstract. Nuclear Medicine is a medical service that uses radioactive for diagnostic and therapeutic purposes. Nuclear Medicine Services involves radiation workers to operate, both health workers and non-health workers. Radiation exposure received by a worker is not allowed to exceed the dosage limitation. The purpose of this research is to find out the description of radiation exposure in each of the profession and to assess if the radiation exposure is within the dosage limitation or exceeds it. The research design used is cross sectional observational descriptive. This research was conducted on Dr. Hasan Sadikin Central General Hospital, MRCCC Siloam Hospital Semanggi, Dr. Kariadi Central General Hospital, and Dharmais Cancer Hospital with a total sample of 100 people. Data were obtained from each of the hospital's radiation exposure records from 2018-2020. Data were grouped based on the professions and were calculated of its highest value, lowest value, mode, and mean. All professions were then categorized based on the value of their radiation exposures. This research was done after it was granted ethical clearance from the ethic committee. The results showed that in general, radiation exposure of all professions for three periods were low and were within safe boundaries. Cleaning services, nurses, and radiopharmacists received the highest average radiation exposure for three periods. Cleaning services, Nuclear Medicine Doctors, and radiopharmacists received the highest radiation exposure in a period. One cleaning service was in the prohibited exposure category (exceeding NBD) in a period. One Nuclear Medicine Doctor and two radiopharmacists were in the exposure limitation category (exceeding optimized exposure) in a period. Abstrak. Kedokteran Nuklir merupakan pelayanan kedokteran yang menggunakan radioaktif dengan tujuan diagnostik dan terapi. Pelayanan Kedokteran Nuklir melibatkan pekerja radiasi dalam pelaksanaannya, baik tenaga kesehatan maupun tenaga non-kesehatan. Paparan radiasi yang diterima oleh seseorang tidak boleh melampaui batasan nilai dosis. Tujuan penelitian ini adalah untuk mengetahui gambaran paparan radiasi pada setiap profesi dan menilai apakah paparan radiasi dalam batas dosis atau melebihi batas dosis. Rancangan penelitian yang digunakan adalah memakai observational deskriptif potong lintang. Penelitian ini dilakukan di Rumah Sakit Umum Pusat Dr. Hasan Sadikin, Rumah Sakit MRCCC Siloam Semanggi, Rumah Sakit Umum Pusat Dr. Kariadi, dan Rumah Sakit Kanker Dharmais dengan jumlah sampel 100 orang. Data diperoleh dari catatan paparan radiasi yang diambil dari tahun 2018-2020. Data disajikan dalam bentuk berkelompok berdasarkan jenis profesinya kemudian dihitung dari nilai tertinggi, nilai terendah, modus, dan meannya. Setiap profesi lalu digolongkan berdasarkan jumlah paparan radiasinya. Penelitian ini dilaksanakan setelah mendapat ethical clearance dari komisi etik penelitian kesehatan. Hasil penelitian menunjukkan bahwa secara umum, paparan radiasi dalam tiga periode pada setiap profesi rendah dan masih dalam batas aman. Cleaning service, perawat, dan radiofarmasis menerima rata-rata paparan radiasi tertinggi dalam tiga periode. Cleaning Service, Dokter Spesialis Kedokteran Nuklir, dan radiofarmasis menerima paparan radiasi tertinggi dalam satu periode. Satu pekerja Cleaning Service termasuk ke kategori paparan larangan (melebihi NBD) dalam satu periode. Satu Dokter Spesialis Kedokteran Nuklir dan dua radiofarmasis termasuk ke kategori limitasi paparan (melebihi pembatas dosis) dalam satu periode.
Prevalence and Analysis of Risk Factors for RAI-Refractory Thyroid Cancer Patients: A 5-Year Retrospective Analysis from a Single Institution in Indonesia Putri, Syifa Azizah; Monty Priosodewo Soemitro; Basuki Hidayat; Kharisma Perdani Kusumahstuti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 11 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i11.1116

Abstract

Background: Radioactive iodine (RAI) therapy is a cornerstone in the management of differentiated thyroid cancer (DTC). However, a subset of patients develops RAI-refractory disease, characterized by the inability to concentrate radioiodine, leading to limited treatment options and a poorer prognosis. This study aimed to investigate the prevalence and identify potential risk factors associated with RAI-refractory DTC in an Indonesian population. Methods: A retrospective analysis was conducted on patients diagnosed with DTC and treated with RAI at a single tertiary care center in Indonesia between 2019 and 2023. Data on demographics, clinical characteristics, tumor features, and treatment outcomes were collected. RAI-refractoriness was defined as the absence of iodine uptake on diagnostic whole-body scans after cumulative RAI activity of 600 mCi or more. Bivariate and multivariate analyses were performed to identify risk factors for RAI-refractoriness. Results: A total of 194 patients with DTC were included in the study. The prevalence of RAI-refractoriness was 90%. The median age at diagnosis was 55 years (range 18-82), and 72% were female. Papillary thyroid carcinoma was the most common histological subtype (92%). In bivariate analysis, older age at diagnosis (p=0.02), male gender (p=0.04), and the presence of distant metastases at diagnosis (p<0.001) were significantly associated with RAI-refractoriness. In multivariate analysis, only the presence of distant metastases remained an independent predictor of RAI-refractoriness (odds ratio 3.8, 95% confidence interval 1.5-9.2, p=0.003). Conclusion: RAI-refractoriness is a significant clinical challenge in the management of DTC, with a high prevalence observed in this Indonesian cohort. The presence of distant metastases at diagnosis emerged as a strong predictor of RAI-refractoriness. Further research is needed to elucidate the underlying mechanisms of RAI-refractoriness and develop novel therapeutic strategies for this patient population.
Co-Authors ABDUL MUTALIB Abdul Mutalib ABDUL MUTALIB Abdul Mutalib Achmad Hussein Sundawa Kartamihardja Adella Puspitasari Agus Arianto, Agus Arlene Angelina Asmarani Kusumawati B. Sardjono Bethy Suryawathy Hernowo Budi - Darmawan Budi Darmawan Budi Darmawan Budi Darmawan CAHYA NOVA ARDIYATNO CECEP TAUFIK RUSTENDI Christian Prijana Christian Prijana, Christian Elma yulius Endah Indriani Endah Indriani Wahyono Erwin Affandi Soeriadi Faisal Faisal Febby Hutomo Febby Hutomo, Febby HAMMAD SUBUR Hanafiah - Wangsaatmadja Hendra Budiawan Hendra Budiawan Hendra Budiawan, Hendra Hendry Johan Renaldy Tandra Herri S. Sastramihardja Herry Herman Herry Sastramihardja Ivana D. Mulyanto Ivana D. Mulyanto, Ivana D. Jessica Ubercaprita Joannes Sri Widada JOHAN MASHYUR JOHAN MASJHUR Johan S. Masjhur Johan S. Masjhur Johan S. Masjhur, Johan S. Karyadi Karyadi KARYADI KARYADI Kharisma Perdani Kusumahstuti Kharisma Perdani Kusumahstuti Kusumahstuti, Kharisma M Aulia Prima Martalena Ramli Martalena Ramli MARTALENA RAMLI Martalena Ramli MARTALENA RAMLI Mas Adi Sunardi MASKUR MASKUR Monty Priosodewo Soemitro mr Karyadi Mrs Sutari mrs Triningsih Muchtaridi Muchtaridi MUHAMMAD SUBUR Noviola Ruth Adisty Nur Rahmah Hidayati Nurlaila Zainuddin Putri, Syifa Azizah Raden Erwin Affandi Soeriadi Koesoemah Reza Rinaldy Harahap RIEN RITAWIDYA RIEN RITAWIDYA Rika Sylviana Rukmini Iljas Ryan Yudistiro Ryan Yudistiro, Ryan Sri Aguswarini SRI AGUSWARINI Sri Aguswarini Sri Setyowati Sri Setyowati SRI SETYOWATI Stepanus Massora Stepanus Massora Stepanus Massora, Stepanus Susilo, Veronica Yulianti Susyati Susyati Sutari Sutari TITIS SEKAR HUMANI Titis Sekar Humani Veronika Yulianti Susilo Veronika Yulianti Susilo Yanti Mulyana Yanti Mulyana