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Automatic whole-body bone scan image segmentation based on constrained local model Ema Rachmawati; Jondri Jondri; Kurniawan Nur Ramadhani; Achmad Hussein Sundawa Kartamihardja; Arifudin Achmad; Rini Shintawati
Bulletin of Electrical Engineering and Informatics Vol 9, No 6: December 2020
Publisher : Institute of Advanced Engineering and Science

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/eei.v9i6.2631

In Indonesia, cancer is very burdensome financially for sufferers as well as for the country. Increasing the access to early detection of cancer can be a solution to prevent the situation from worsening. Regarding the problem of cancer lesion detection, a whole-body bone scan image is the primary modality of nuclear medicine for the detection of cancer lesions on a bone. Therefore, high segmentation accuracy of the whole-body bone scan image is a crucial step in building the shape model of some predefined regions in the bone scan image where metastasis was predicted to appear frequently. In this article, we proposed an automatic whole-body bone scan image segmentation based on constrained local model (CLM). We determine 111 landmark points on the bone scan image as the input for the model building step. The resulting shape and texture model are further used in the fitting step to estimate the landmark points of predefined regions. We use the CLM-based approach using regularized landmark mean-shift (RLMS) to lessen the effect of ambiguity, which was struggled by the CLM-based approach. From the experimental result, we successfully show that our proposed image segmentation system achieves higher performance than the general CLM-based approach.

BIODISTRIBUSI 177LUTETIUM-(R)-NODAGA-PSMA PADA GINJAL DAN KANDUNG KEMIH TIKUS GALUR WISTAR JANTAN Brigitta Silalahi; Achmad Hussein Sundawa Kartamihardja; N. Elly Rosilawati; Rini Shintawati; Nur Rahmah Hidayati
Jurnal Sains dan Teknologi Nuklir Indonesia (Indonesian Journal of Nuclear Science and Technology) Vol 20, No 1 (2019): Februari 2019
Publisher : BATAN

177Lutetium (Lu) –(R)-NODAGA-PSMA merupakan perkembangan terapi radionuklida yang dapat digunakan untuk terapi metastasized castration-resistant prostate cancer (mCRPC). Penelitian ini dilakukan untuk mengetahui biodistribusi 177Lu–(R)-NODAGA-PSMA pada ginjal dan kandung kemih hewan coba berupa tikus galur wistar jantan. Penelitian eksperimental laboratorik ini dilakukan di laboratorium Departemen Ilmu Kedokeran Nuklir dan Pencitraan Molekuler RSUP Dr. Hasan Sadikin Bandung. Subjek penelitian adalah 10 tikus galur wistar jantan dengan usia 8-12 minggu; berat 200-250 gram; dalam keadaan sehat. Tikus akan ditidurkan dengan agen anestesi ketamin, lalu dilakukan injeksi 1,3-1,7 mCi radiofarmaka 177Lu–(R)-NODAGA-PSMA pada vena bagian ekor. Perhitungan cacahan organ total dilakukan pada menit ke 60,90, dan 120, pasca injeksi radiofarmaka 177Lu–(R)-NODAGA-PSMA sebesar 1.300-1.700 mCi pada vena bagian ekor. Hasil yang diperoleh dari uji adalah tangkapan ginjal dan kandung kemih.Rata-rata persentase tangkapan radiofarmaka pada menit ke-60 adalah ginjal kanan sebesar 4,35%, ginjal kiri 5,91%, kandung kemih 6,54%; pada menit ke-90 adalah ginjal kanan sebesar 6,31%, ginjal kiri 7,6%, kandung kemih 7,95%; serta pada menit ke-120 adalah ginjal kanan sebesar 6,89%, ginjal kiri 8,48%, kandung kemih 9,60%. Hasil persentase tangkapan organ target akan disajikan dalam tabel dan grafik.Biodistribusi radiofarmaka 177Lu–(R)-NODAGA-PSMA pada tikus galur wistar jantan ditangkap oleh ginjal kanan dan kiri serta kandung kemih. Peningkatan radioaktivitas tangkapan organ target tercatat seiring dengan berjalannya waktu penelitian. Hal ini disebabkan karena ginjal berperan sebagai organ ekskresi dari radiofarmaka.

DETEKSI KEBOCORAN CAIRAN LIQUOR DENGAN PEMERIKSAAN SPECT/CT SISTERNOGRAFI RADIONUKLIDA Kharisma Perdani Kusumahstuti; David Siahaan; Rian Hidayatullah; Achmad Hussein Sundawa Kartamihardja
Unram Medical Journal Vol 11 No 2 (2022): vol 11 no 2 2022
Publisher : Faculty of Medicine Universitas Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jku.v11i2.713

Radionuclide cisternography is often used to prove the presence of cerebrospinal fluid leakage from the nose or ears and to localize the location of the leak. Whether the leak is active or not at the time of examination greatly affects the results of the radionuclide examination. We report a rare study case in a female patient 56 years old, who had the main complaints of nasal discharge, apathy, and weakness. The discharge is mainly felt when the patient is sitting. The patient had a history of transsphenoidal surgery for removal tumor at the epiphyses. Cisternography examination was carried out at the Department of Nuclear Medicine and Molecular Theranostic to confirm a liquor leak in the patient. Imaging was performed at 1.3.6 hours after intrathecal 99mTc-DTPA injection. There is an increase in radioactivity in the nasal area, especially on the 3 hour image. SPECT / CT fusion imaging provides the exact location of the liquor leak at the sphenoid area. The nasal tampon to blood serum ratio is 4: 1. Therapy for the patient is surgery to re-seal the leak.

The Appropriate Acquisition Time Interval Following Injection of 99mTc-Sestam ibi with Water Protocol in Single Photon Emission Computed Tomography Myocardial Perfusion Imaging: First Experience in Indonesia Nora Anggun Prasetyo; Erwin Affandi Soeriadi; Hendra Budiawan; Achmad Hussein Sundawa Kartamihardja
Medicinus Vol 10, No 2 (2022): June 2022 - September 2022
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v10i2.5677

Introduction: According to EANM/ESC guideline, image acquisitions in stress test should be begun at 30-60 minutes after tracer administration. Our center is a referral hospital for nuclear medicine imaging with many patients but limited number of gamma camera. The shorter time between injection of radiopharmaceutical and imaging acquisition will add to the number of examinations that can be performed. The aim of this study was to evaluate the appropriate acquisition time interval with water protocol in 99mTc-Sestamibi SPECT myocardial perfusion imaging.Methods: Patients who were referred to undergo stress MPI between October 2020 to December 2020 were included in this study. Cardiac stress procedure was performed using treadmill with modified Bruce Protocol. Subjects drank a total of 330 mL water following 99mTc-Sestamibi injection. Image acquisitions were performed 10 and 30 minutes afterwards. Quantitative assessment was done by calculating target background ratio (TBR). Statistical analysis was performed using student t-test with Microsoft Excel version 2019. P-value < 0.05 was considered to be statistically significant.Result: Thirty out of 35 subjects were included in this study. Sixteen of them are male and 14 are female with a mean age of 48.7 years old (28 – 80). Mean target background uptake ratio (TBR) in 10- and 30-minutes images were 0.67 (0.44 – 1.11) and 0.76 (0.43 – 1.18) respectively (p-value = 0.15).Conclusion: There was no significant difference of target to background ratio between 10- and 30-minutes acquisition time interval following injection of 99mTc-Sestamibi with water protocol in myocardial perfusion imaging.

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

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.

Breast Cancer Awareness among Bandung Adolescents Mutiara Aini Majid; Arifudin Achmad; Holis Abdul Holik; Achmad Hussein Sundawa Kartamihardja
Jurnal Pengabdian kepada Masyarakat (Indonesian Journal of Community Engagement) Vol 8, No 1 (2022)
Publisher : Direktorat Pengabdian kepada Masyarakat Universitas Gadjah Mada

Most breast cancer patients in Indonesia experienced a delay in their diagnosis due to a lack of awareness and other factors. Female adolescents are the key population for an educational intervention to raise breast cancer awareness. This study assessed knowledge of breast cancer risk factors, signs, and symptoms, attitudes toward breast cancer prevention, barriers in breast cancer screening, and behavior regarding breast cancer awareness among female adolescents in Bandung using the Breast Cancer Awareness Scale – Indonesia (BCAS-I) instrument. Among 371 female high school and undergraduate students, 53.1% of them had limited knowledge about breast cancer risk factors, and 99.2% of these respondents had negative behaviors. However, most of them understood the early breast cancer signs and symptoms (89.8%) and had positive attitudes toward seeking health support (98.7%). Preference of health information sources and educational level are the significant factors for breast cancer awareness. Our initial assessment may provide the basis for further research and surveys on a larger scale to develop breast cancer prevention educational materials appropriate for young female populations.

The Appropriate Acquisition Time Interval Following Injection of 99mTc-Sestam ibi with Water Protocol in Single Photon Emission Computed Tomography Myocardial Perfusion Imaging: First Experience in Indonesia Prasetyo, Nora Anggun; Soeriadi, Erwin Affandi; Budiawan, Hendra; Kartamihardja, Achmad Hussein Sundawa
Medicinus Vol 12, No 1 (2022): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v10i2.7016

Introduction: According to EANM/ESC guideline, image acquisitions in stress test should be begun at 30-60 minutes after tracer administration. Our center is a referral hospital for nuclear medicine imaging with many patients but limited number of gamma camera. The shorter time between injection of radiopharmaceutical and imaging acquisition will add to the number of examinations that can be performed. The aim of this study was to evaluate the appropriate acquisition time interval with water protocol in 99mTc-Sestamibi SPECT myocardial perfusion imaging.Methods: Patients who were referred to undergo stress MPI between October 2020 to December 2020 were included in this study. Cardiac stress procedure was performed using treadmill with modified Bruce Protocol. Subjects drank a total of 330 mL water following 99mTc-Sestamibi injection. Image acquisitions were performed 10 and 30 minutes afterwards. Quantitative assessment was done by calculating target background ratio (TBR). Statistical analysis was performed using student t-test with Microsoft Excel version 2019. P-value < 0.05 was considered to be statistically significant.Result: Thirty out of 35 subjects were included in this study. Sixteen of them are male and 14 are female with a mean age of 48.7 years old (28 – 80). Mean target background uptake ratio (TBR) in 10- and 30-minutes images were 0.67 (0.44 – 1.11) and 0.76 (0.43 – 1.18) respectively (p-value = 0.15).Conclusion: There was no significant difference of target to background ratio between 10- and 30-minutes acquisition time interval following injection of 99mTc- Sestamibi with water protocol in myocardial perfusion imaging.

Studi In Silico Senyawa 5-BOTP dan ADPB sebagai Senyawa Pembawa Radioteranostik terhadap LAT-1 Holik, Holis Abdul; Elaine, Angela Alysia; Sitinjak, Bernap Dwi Putra; Qolbina, Shofura Marsa; Ibrahim, Faisal Maulana; Achmad, Arifudin; Sudarmanto, B.S. Ari; Kartamihardja, Achmad Hussein Sundawa
Indonesian Journal of Pharmaceutical Science and Technology Vol 11, No 3 (2024)
Publisher : Indonesian Journal of Pharmaceutical Science and Technology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/ijpst.v11i3.55077

Kompleksitas patogenesis kanker membuat kanker sulit untuk menemukan target terapi yang tepat, sehingga tingkat keberhasilan obat baru dalam uji klinis rendah. Oleh karena itu, studi pengembangan teknik intervensi yang baru untuk pasien kanker sangat penting. Large-type Amino Acid Transporter 1 (LAT-1) diekspresikan secara berlebihan dalam sel kanker jika dibandingkan dengan sel normal, hal ini menjadikannya salah satu target molekuler khusus untuk terapi kanker. Fungsi LAT-1 adalah memberikan nutrisi pada sel kanker untuk berkembang biak secara masif sehingga penghambatan LAT-1 dapat dijadikan alternatif terapi kanker. Penelitian ini bertujuan untuk mendapatkan senyawa potensial yang akan digunakan untuk radioteranostik dengan dua senyawa inhibitor LAT-1 sebagai senyawa pembawa, yaitu 5-Benzyloxytryptophan (5-BOTP) dan asam (S)-2-amino-4-(3,5-diklorofenil) butanoat (ADPB) yang dikonjugasikan dengan senyawa linker dan berbagai agen pengkelat bifungsional (BFCA) terhadap situs antiporter LAT-1. Metode penelitian terdiri dari mode pengikatan senyawa 5-BOTP dan ADPB terkonjugasi dengan LAT-1, simulasi penambatan molekuler, dan analis pre-ADMET. Hasil penelitian menunjukkan bahwa 5-BOTP-6AHA-H2CB-DO2A dan ADPB-6AHA-H2CB-DO2A memiliki afinitas terbaik dan kompleks pengikatan yang terbaik dengan LAT-1 sehingga keduanya berpotensi sebagai agen radioteranostik kanker dengan menghambat LAT-1.Kata kunci: Kanker, radioteranostik, LAT-1, 5-Benzyloxytryptophan, asam (S)-2-amino-4-(3,5-diklorofenol) butanoat.

Hyperthyroidism-Induced Myocardial Ischemia: Quantification and Correlation with fT4 via 99mTc-Sestamibi Scintigraphy Daniel Chung; Achmad Hussein Sundawa Kartamihardja; Raden Erwin Affandi Soeriadi Koesoemah
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i7.1336

Background: Hyperthyroidism exerts significant detrimental effects on the cardiovascular system, increasing the risk of major adverse cardiac events (MACE). While associations with atrial fibrillation and cardiomyopathy are well-documented, the incidence and characteristics of myocardial ischemia, particularly assessed by functional imaging, remain less explored. This study aimed to investigate the incidence of myocardial ischemia in hyperthyroid patients using Technetium-99m Sestamibi (⁹⁹ᵐTc-Sestamibi) myocardial perfusion scintigraphy (MPS) and correlate findings with thyroid hormone levels. Methods: This prospective preliminary study enrolled fifteen consecutive patients with confirmed hyperthyroidism and no prior history of ischemic heart disease between January and April 2024. All subjects underwent thyroid function tests (TSH, fT4, T3) and a one-day rest/adenosine-stress ⁹⁹ᵐTc-Sestamibi MPS protocol. Myocardial ischemia presence, reversibility, severity (Summed Stress Score, SSS), and extent (total ischemic segments) were assessed using the AHA 17-segment model. Spearman correlation was used to analyze the relationship between hormone levels and MPS parameters. Results: Fifteen subjects (93.3% female, mean age 34 ± 11 years) were included. Myocardial ischemia was detected in 14/15 subjects (93.3%). Among those with ischemia, 12 (80% of total subjects, 85.7% of ischemic subjects) exhibited reversible defects. Free thyroxine (fT4) levels showed a strong positive correlation with SSS (rs = 0.64, p = 0.01) and the total number of ischemic segments (rs = 0.65, p = 0.01). Conclusion: This preliminary study revealed a high incidence of myocardial ischemia, predominantly reversible, in patients with hyperthyroidism detected by ⁹⁹ᵐTc-Sestamibi MPS. The severity and extent of ischemia demonstrated a significant positive correlation with fT4 levels. These findings underscore the potential utility of MPS in cardiovascular risk assessment and suggest the need for comprehensive cardiac evaluation in hyperthyroid patients, particularly those with higher fT4 levels.

Hyperthyroidism-Induced Myocardial Ischemia: Quantification and Correlation with fT4 via 99mTc-Sestamibi Scintigraphy Daniel Chung; Achmad Hussein Sundawa Kartamihardja; Raden Erwin Affandi Soeriadi Koesoemah
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i7.1336

Background: Hyperthyroidism exerts significant detrimental effects on the cardiovascular system, increasing the risk of major adverse cardiac events (MACE). While associations with atrial fibrillation and cardiomyopathy are well-documented, the incidence and characteristics of myocardial ischemia, particularly assessed by functional imaging, remain less explored. This study aimed to investigate the incidence of myocardial ischemia in hyperthyroid patients using Technetium-99m Sestamibi (⁹⁹ᵐTc-Sestamibi) myocardial perfusion scintigraphy (MPS) and correlate findings with thyroid hormone levels. Methods: This prospective preliminary study enrolled fifteen consecutive patients with confirmed hyperthyroidism and no prior history of ischemic heart disease between January and April 2024. All subjects underwent thyroid function tests (TSH, fT4, T3) and a one-day rest/adenosine-stress ⁹⁹ᵐTc-Sestamibi MPS protocol. Myocardial ischemia presence, reversibility, severity (Summed Stress Score, SSS), and extent (total ischemic segments) were assessed using the AHA 17-segment model. Spearman correlation was used to analyze the relationship between hormone levels and MPS parameters. Results: Fifteen subjects (93.3% female, mean age 34 ± 11 years) were included. Myocardial ischemia was detected in 14/15 subjects (93.3%). Among those with ischemia, 12 (80% of total subjects, 85.7% of ischemic subjects) exhibited reversible defects. Free thyroxine (fT4) levels showed a strong positive correlation with SSS (rs = 0.64, p = 0.01) and the total number of ischemic segments (rs = 0.65, p = 0.01). Conclusion: This preliminary study revealed a high incidence of myocardial ischemia, predominantly reversible, in patients with hyperthyroidism detected by ⁹⁹ᵐTc-Sestamibi MPS. The severity and extent of ischemia demonstrated a significant positive correlation with fT4 levels. These findings underscore the potential utility of MPS in cardiovascular risk assessment and suggest the need for comprehensive cardiac evaluation in hyperthyroid patients, particularly those with higher fT4 levels.

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