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Comparison of Dose Distribution with Graphical Optimization and Inverse Planning Techniques in Cervical Cancer Brachytherapy Ni Nyoman Ratini; I Putu Wesa Angga Jaya; Gusti Ngurah Sutapa; I Putu Tedy Indrayana; Ni Putu Yuni Nurmalasari; I Wayan Balik Sudarsana
Jurnal Penelitian Pendidikan IPA Vol 12 No 2 (2026)
Publisher : Postgraduate, University of Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jppipa.v12i2.12900

Abstract

Cervical cancer is the leading cause of death among women in Indonesia, with 36,964 new cases reported in 2022. Brachytherapy is a key component in treating advanced-stage cervical cancer, where dose optimization is critical to maximize the target dose (HRCTV) and minimize exposure to organs at risk. Graphical Optimization (GrO) and Inverse Planning (IP) techniques are commonly used, but comparative studies using Co-60 sources remain limited. Previous studies have largely used Ir‑192, so this study explores the comparison of GrO versus IP using Co‑60, which has not been widely studied in Indonesia. Co‑60 was chosen because it provides a dose distribution comparable to Ir‑192, has a longer half‑life reducing the frequency of source replacements and maintenance costs and has been reported to shorten patient treatment time by approximately 10%. This study compared the dose distribution of both techniques in 30 brachytherapy patients treated with a Co-60 source at Prof. Dr. I.G.N.G. Ngoerah Hospital. Data were analyzed using the Sagiplan 2.2.1 Treatment Planning System (TPS) following the TG-43 protocol. Evaluations included D90 HRCTV, COIN, DHI, bladder D2cc, and rectum D2cc based on ICRU Report 89 recommendations. MANOVA results (SPSS 29.0; significance < 0.05) showed that GrO’s D90 HRCTV (7.239 Gy ± 0.134 Gy) was significantly higher (sig = 0.006) than IP (7.155 Gy ± 0.093 Gy). GrO’s DHI (0.352 ± 0.043) was also superior (sig = 0.030), while COIN, bladder D2cc, and rectum D2cc showed no significant differences. Overall dose distribution for GrO differed significantly from IP (p = 0.011), though all parameters met ICRU standards. Conclusion: GrO excels in target coverage and homogeneity, while IP is equivalent in OAR protection. Both techniques are dosimetrically feasible, but GrO is more adaptive for complex anatomies despite requiring longer planning time.
Measurement of CT Number Uniformity Value at Various X-ray Tube Current Settings in CT Scanning Ni Nyoman Ratini; Gusti Ngurah Sutapa; Ni Kadek Nova Anggarani; I Gde Antha Kasmawan; Anastasia Jessing Gamalita Mberato
Jurnal Penelitian Pendidikan IPA Vol 11 No 1 (2025): January
Publisher : Postgraduate, University of Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jppipa.v11i1.8527

Abstract

Studies on the analysis of variations in CT number uniformity values for CT-Scan images has been conducted. This study aims to evaluate the image quality value by uses various tube currents (mAs) in Siemens merk water phantom irradiation to assess the value of image quality. A Siemens Somatom Scope CT-Scan with current variations of 180 mAs, 200 mAs, 220 mAs, 240 mAs, and 260 mAs was used. The image results were then anlyzed for quality through the CT number uniformity value test. Using a marker size of 12.56 cm2, the ROI method was applied at five different picture points: the center, 3, 6, 9, and 12 o'clock. For each current variation used in this study, 3 irradiation was carried out and 5 image slices were taken from each irradiation.This resulted of the analysis the CT number uniformity value was shown to be significantly reduced by the tube current strength (R2=0.9896, p-value<0.05), according to the research. The test showed that the uniformity CT number value decreased from 0.217 HU to 0.031 HU as the tube current strength was increased, bringing it closer to the reference value (0 HU). The consistency CT number values acquired in this study remain within the 2 HU tolerance limits established by BAPETEN.
Uji Kesesuaian Generator Tabung Sinar-X dan Automatic Exposure Control (AEC) pada Mamografi Digital di RSD Mangusada Badung Johanes J. Silalahi; Gusti Ngurah Sutapa; I Nyoman Pranditayana; I Nengah Sandi; I Gde Antha Kasmawan; Ni Putu Yuni Nurmalasari
Kappa Journal Vol 8 No 2 (2024): Kappa Journal
Publisher : Universitas Hamzanwadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29408/kpj.v8i2.24341

Abstract

This study focuses on evaluating the quality and performance of the digital mammography system at Mangusada Badung Regional Hospital (RSD) in an effort to prevent and early detect breast cancer. With the prevalence and mortality rate of breast cancer continuing to increase, early detection is important. Digital mammography has an important role in this early detection. This study aims to evaluate the performance of digital mammography at Radiology Installation Mangusada Badung through a series of tests. generator and x-ray tube suitability test and automatic exposure control (AEC). The results showed conformity tests on voltage accuracy (maximum error 0.8%), linearity (CL 0.01), reproducibility (radiation output CV 0.001, peak voltage CV 0.003), emergency timer (stops at 0 mAs), tracking (% patient thickness % exposure index error 7.9%, voltage exposure index error 6%), AEC (voltage CV 0.000, current time CV 0.000), exposure time (large focus t 0.87 seconds, small focus t 1.21 seconds). The test results show that the digital mammography system meets the conformity test criteria in accordance with PERKA BAPETEN no. 2 of 2022. This provides confidence that the device meets the established quality standards. With this fulfillment, it is expected that the accuracy of diagnosis can be improved and the risk of errors in early detection of breast cancer can be reduced. Therefore, the digital mammography system at RSD Mangusada Badung is expected to be.
The Effect of Time Repetition Variation on Brain MRI Imaging Quality On T2 Weighted Sequences Ade Rama Ditya Arsana Karang; Gusti Ngurah Sutapa; I Putu Surya Dharma Negara
Kappa Journal Vol 8 No 1 (2024): Kappa Journal
Publisher : Universitas Hamzanwadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29408/kpj.v8i1.24885

Abstract

Magnetic Resonance Imaging (MRI) is an imaging technique used to produce images of parts of the human body by utilizing a strong magnetic field. The examination that is often carried out is a brain examination. This research was conducted at Bali Mandara Hospital. To find out the condition of the brain, an MRI examination can be done. MRI can produce images known as sequences which produce T1 Weighted Image (T1WI), T2 Weighted Image (T2WI), resulting in visible images with different intensities. To obtain T2WI, the time echo (TE) and time repetition (TR) must be long to give the fat and water a chance to decay, so that the fat and water contrast can be visualized well. This research aims to determine the effect of TR variations on SNR values, and determine the best TR to produce good image values. To generate T2WI SNRs on brain MRI. This street vendor activity uses a Phillips 1.5 Tesla type MRI aircraft. Data collection was obtained from twenty patients with 3 variations of TR values starting from 3,500 ms, 5,500 ms and 7,500 ms by obtaining a total of 60 images. Evaluate tissue SNR values by measuring ROI directly on the MRI device. SNR value analysis was performed on cerebrospinal fluid (CSF) tissue, spinal cord. Sequentially the SNR values obtained were 174.24, 211.22 and 244.51 in the CSF tissue 78.53, 80.64 and 84.81 in the spinal cord tissue. This street vendor activity has shown the result that the longer the TR value is given, the SNR value will increase. This is because long TR values are able to evaluate networks in more slices and provide better noise signal values. The TR variation of 7,500 ms can produce the highest SNR value so that the resulting image is very good
Analisis Laju Dosis Radiasi di Area Ruang CT_Scan di Instalasi Radiologi RSU Bali Mandara Else Putri Ayu Prameswari; Gusti Ngurah Sutapa; I Gusti Agung Ayu Ratnawati; Ni Nyoman Ratini; I Nengah Artawan; Ni Luh Putu Trisnawati
Kappa Journal Vol 8 No 2 (2024): Kappa Journal
Publisher : Universitas Hamzanwadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29408/kpj.v8i2.25211

Abstract

Research has been carried out on radiation dose rate analysis in the CT-SCAN area of the radiology room at RSU Mandara Bali. The data used in this research is quantitative data observed from the radiation rate from the CT-SCAN aircraft. This study aims to determine the radiation dose rate in the radiology area and its rationalization based on regulations regarding radiation NBD (dose limit values) that apply to occupational safety and health. The research data is the actual radiation dose rate determined from the dose rate and calibration factors. The results of data calculations show that the highest dose rates are respectively at T2, 30 cm, 50 cm and 100 cm (door) with values of 1.95, 0.94 and 0.05 μSv/year, while the lowest dose rates are respectively at T4, 30 cm, 50 cm and 100 cm (waiting room) with values of 0.08, 0.06 and 0.05 μSv/year. The research results show that the dose rate at each measurement point is still considered safe for radiation workers where the NBD received is still below 20 μSv/year, while the dose rate is classified as safe for the general public at measuring distances of 50 cm and 100 cm, where the NBD received is below 1 μSv/year assuming the community concerned acts as a patient or patient's family with an interest in the radiology room area.
Identifikasi Citra Radiografi Sinar-X Pemeriksaan Thorax Untuk Penderita Covid-19 Di Instalasi Radiologi RSUP Prof. I. G. N. G Ngoerah Gusti Ngurah Sutapa; Asril Hanzani; Wayan Balik Sudarsana; Ni Nyoman Ratini; Ni Luh Putu Trisnawati; Winardi Tjahyo Baskoro
Kappa Journal Vol 8 No 2 (2024): Kappa Journal
Publisher : Universitas Hamzanwadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29408/kpj.v8i2.25290

Abstract

Coronavirus Desease 2019 (Covid-19) merupakan penyakit menular yang disebabkan oleh virus Sars-Cov-2. Gejala yang ditimbulkan antara lain demam, batuk kering, dan sesak napas. Berbagai upaya penanganan dan pencegahan dilakukan oleh tenaga medis di Indonesia. Salah satu rumah sakit yang ikut andil menangani hal tersebut adalah RSUP Prof. Dr. I. G. N. G Ngoerah yang ada di Provinsi Bali menggunakan pemeriksaan thorax dengan pesawat sinar-X (rontgen). Penelitian ini dilakukan dengan menggunakan data sekunder yaitu 30 data pasien non-Covid-19 dan 30 data pasien Covid-19 di RSUP Prof. Dr. I. G. N. G Ngoerah pada tahun 2020 sampai dengan tahun 2022 dengan membandingkan hasil citra pasien secara kualitatif dari pembacaan dokter radiolog dan secara kuantitatif dilihat dari nilaia Efekti Dose (ED) dan Indeks Exsposure (IE). Dari hasil citra, pasien covid-19 menunjukkan adanya bercak-bercak putih pada bagian paru-paru dan dari hasil pembacaan dokter rata-rata pasien covid-19 mengalami pneumonia atau peradangan pada paru-paru sedangkan pada pasien non-covid-19 tidak mengalami pneumonia. Secara kuantitatif rata-rata nilai ED pada pasien non-covid-19 lebih besar dibandingkan pada pasien covid-19. Secara berturut-turut yaitu 0,1267±0,00653 mSv dengan nilai minimum 0,0694 serta nilai maximum 0,214 dan 0.0914±0,0311 mSv minimum 0,0096 serta maximum 0,706.  namun nilai IE pada pasien covid-19 lebih besar dibandingkan dengan pasien non-covid-19, yaitu 267,3±9,059 mSv dengan nilai minimum 202 mSv dan maximum 396,1 mSv. Sedangkan pasien non-Covid-19 besar nilai minimum 129 mSv dan maximum 172,9 mSv dengan rata-rata 146,467±2,45 mSv, dengan persentase perbandingan yaitu 35%:65%. Untuk menunjang terhadap perbedaan yang terjadi maka dilakukan uji statistik menggunakan T-test statistik nonparametric. Syarat signifikansi Asimp.Sig<0,05 menunjukkan perbedaan yang signifikan antara IE pasien non-Covid-19 dengan IE pasien Covid-19. Sehingga hasil statistik juga mendukung terhadap hasil pembacaan IE pada citra radiografi bahwa terjadi perbedaan yang signifikan antara nilai IE pada citra radiografi pasien non-Covid-19 dengan pasien Covid-19.
Penentuan Nilai Computed Tomography Dose Index (CTDIvol) dan Dose Length Product (DLP) Pesawat CT-Scan kepala pada kasus Stroke Non Hemoragik (SNH): Determination of Computed Tomography Dose Index (CTDIvol) and Dose Length Product (DLP) values of head CT-Scan aircraft in cases of Non Hemorrhagic Stroke (SNH) Nabilla Fatimah; Gusti Ngurah Sutapa; Wayan Balik Sudarsana; Ni Nyoman Ratini; Putu Suardana; I Ketut Putra
Kappa Journal Vol 8 No 2 (2024): Kappa Journal
Publisher : Universitas Hamzanwadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29408/kpj.v8i2.25599

Abstract

A study was conducted on the determination of Computed Tomography Dose Index (CTDIvol) and Dose Length Product (DLP) values of head CT-Scan aircraft in cases of Non Hemorrhagic Stroke (SNH). The study was conducted at the Radiology Installation of Prof.Dr. I.G.N.G. Ngoerah Denpasar Hospital using secondary data from head CT-Scan examination results consisting of age, gender, kV, mAs, slice thickness, rotation time, CTDIvol and DLP in patients aged 40-80 years. This study aims to determine the local DRL value at Prof.Dr. I.G.N.G. Ngoerah Denpasar Hospital does not exceed the national DRL value. It was found that in female patients the CTDIvol value in male patients was 54.9 mGy and in female patients it was 53.11 mGy. While the DLP value of male patients was 1143 mGy.cm and in female patients it was 1118 mGy.cm. Based on the results of the analysis with a one-way t-test, it can be seen that the DRL values of CTDIvol and DLP in both male and female patients do not exceed the standards set by BAPETEN No.1211/K/V/2021, so it can be said that the CT-Scan at the Radiology Installation of Prof.Dr. I.G.N.G. Ngoerah Denpasar Hospital is still suitable for use in examinations, especially head examinations.
Analisis Laju Dosis Radiasi Neutron Pada Pekerja Radiasi Menggunakan Surveymeter di Instalasi Radioterapi Ida Bagus Putu Priastana Bawa; Ni Nyoman Ratini; Wayan Balik Sudarsana; Gusti Ngurah Sutapa; I Made Satriya Wibawa; I Gde Antha Kasmawan; Rozi Irhas
Kappa Journal Vol 8 No 3 (2024): Kappa Journal
Publisher : Universitas Hamzanwadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29408/kpj.v8i3.27296

Abstract

The research was carried out at the Radiotherapy Installation at Hospital Prof. Dr. I.G.N.G. Work with the aim of knowing the value of the neutron radiation dose rate at the maximum point after the irradiation is carried out and knowing the value of the neutron radiation dose rate to radiation workers based on the Dose Limit Value permitted by BAPETEN. The research was carried out by measuring the neutron radiation dose rate using a neutron surveymeter at 7 different points with a photon beam of 10 MV energy. At point A, the average value of the neutron radiation dose rate at the maximum point was 6618.87 ± 959.50 µSv/h, at point B it was 1586.99 ± 113.95 µSv/h, at point C it was 1599.90 ± 210.98 µSv/h, at point D it is 1236.83±113.94 µSv/h, at point E it is 297.48±41.79 µSv/h, at point F it is 23.69±3.14 µSv/h h and at point G of 0.54 ± 0.44 µSv/h. Then the value of the equivalent dose rate of neutron radiation at each point is obtained, namely, at point A it is 1.8 µSv/h, at point B 3.2 µSv/h, at point C 3.5 µSv/h, at point D 2 .3 µSv/h, at point E 2.3 µSv/h, at point F 2 µSv/h and at point G 1.9 µSv/h, then the equivalent dose rate value is compared with 1/2 NBD of radiation workers of 5 µSv /h, then the equivalent dose rate value is still below 1/2 of the NBD of radiation workers and the SPO that applies at the Radiotherapy Installation at Hospital Prof. Dr. I.G.N.G. Ngoerah is indeed safe for radiation workers.
Menentukan Potensi Resiko Kanker pada Pemeriksaan CT Scan Toraks dengan Metode SSED Gusti Ngurah Sutapa; Ni Putu Aprillia Artanti Phalosa; I Wayan Balik Sudarsana; Ni Nyoman Ratini; I Made Yuliara; I Wayan Supardi
Kappa Journal Vol 8 No 3 (2024): Kappa Journal
Publisher : Universitas Hamzanwadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29408/kpj.v8i3.27804

Abstract

This study aims to determine the potential risk of thoracic organ cancer in CT Scan examinations using the Size-Specific Effective Dose (SSED) method, considering the importance of accurate radiation dose measurement to minimize the risk of cancer due to radiation exposure. The analysis was conducted on 30 female patients and 30 male patients in the adult category (17 - 45 years) at the Radiology Installation of Prof. Dr. I G. N. G. Ngoerah Hospital, Denpasar, using a descriptive quantitative approach with secondary data. The results showed that the Size-Specific Dose Estimate (SSDE) and SSED values ​​in female patients were 6.51 ± 0.70 mGy and 2.95 ± 0.48 mSv, respectively, while in male patients they were 6.38 ± 0.49 mGy and 2.27 ± 0.26 mSv. The risk of cancer in female patients is estimated at 0.016% and in male patients it is 0.012%. The Anova test showed a significant difference between the dose values ​​of the SSDE and SSED methods, which was caused by SSED only considering the dose of organs covered in the CT Scan image. However, the t-test showed that the doses from both methods did not exceed the BAPETEN standard No. 8 of 2011, so that the thoracic CT Scan examination in this Installation is safe and feasible to use.  
The Effect of Focus Film Distance Variation on Patient Absorbed Dose in Thorax Examination with Roentgen Machine in Radiology Installation of Sanjiwani Hospital Gianyar I Nyoman Yosua; Gusti Ngurah Sutapa; I Ketut Putra; Ida Bagus Suryatika; Hery Suyanto; Ida Bagus Alit Paramarta
Kappa Journal Vol 8 No 3 (2024): Kappa Journal
Publisher : Universitas Hamzanwadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29408/kpj.v8i3.28113

Abstract

A study has been conducted on the effect of Focus Film Distance (FFD) variation on patient absorbed dose during thorax examination at the Radiology Installation of Sanjiwani Hospital, Gianyar. This study aims to determine the effect of FFD variation and the suitability of the radiation dose received by patients whether it is still within the limits of BAPETEN's decision. The X-ray machine used was Siemens Luminos Fusion Roentgen with the FFD variation method given a distance of 110 cm, 130 cm, and 150 cm in 30 patients. Dose measurements were carried out based on radiation exposure and analyzed according to BAPETEN standards. The results showed that the greater the FFD value, the smaller the absorbed dose received by patients. The highest absorbed dose obtained for FFD 110 cm was 0.3867 mGy, 130 cm was 0.2769 mGy, and 150 cm was 0.2079 mGy below the maximum limit of 0.4 mGy set by BAPETEN, so it is safe for patients. Statistical analysis of one-way t-test showed significant results, with thitung < ttabel. This indicates that FFD variation affects the absorbed dose, and all doses remain within safe limits. Thus, thorax examination at RSUD Sanjiwani Gianyar has met the established safety standards.
Co-Authors A. A. Ngurah Gunawan A. A. Ngurah Gunawan Ade Nisa Dali Sinaga Ade Rama Ditya Arsana Karang Adnyana, I Gusti Agung Putra Agnes Maria Salvi Anastasia Victor Anastasia Jessing Gamalita Mberato Artawan, I Nengah Asril Hanzani Aulia Nur Aisah Ayu Ratnawati, I Gusti Agung Balik Sudarsana Br Ginting, Venesia Sesilia Chasbas Putra Tamba Choirul Anam AM Diponegoro Cory Amelia Djarwani Soejoko Eka Saputra Else Putri Ayu Prameswari Elshaday S.B Siregar Farah Sukmana Gde Ari Mas Janudinata Hendra Setiawan Hery Suyanto Huki, Pascalia Agno Marina I Dewa Ayu Sintiya Biantari I Gde Antha Asmawan I Gde Antha Asmawan I Gde Antha Kasmawan I Gusti Agung Ayu Ratnawati I Gusti Agung Ngurah Ari Kusuma Putra I Ketut Putra I Ketut putra, I Ketut I Made Gede Mas Prawistya Putra I Made Hendra Hadinata I Made Raditya Anandika Putra I Made Yuliara I Nengah Artawan I Nengah Sandi I Nengah Sandi I Nengah Simpen I Nyoman Pranditayana I Nyoman Yosua I Putu Surya Dharma Negara I Putu Tedy Indrayana I Putu Tedy Indrayana I Putu Wesa Angga Jaya I Wayan Balik Sudarsana I Wayan Balik Sudarsana I Wayan Balik Sudarsana I Wayan Balik Sudarsana I Wayan Balik Sudarsana I Wayan Balik Sudarsana I Wayan Balik Sudarsana I Wayan Balik Sudarsana I Wayan Gede Suharta I Wayan Putu Sutirta Yasa I Wayan Supardi I. B. Alit Paramarta I. G. Antha Kasmawan I. M. Yuliara I. M. Yuliara I.M. Yuliara Ida Ayu Putu Aristia Hutami Ida Bagus Alit Paramarta Ida Bagus Alit Paramartha Ida Bagus Made Suryatika Ida Bagus Putra Manuaba Ida Bagus Putu Priastana Bawa Ida Bagus Suryatika Johanes J. Silalahi Kadek Miniati Kadek Sumaja Kadek Yuda Astina Ketut Putra Komang Ngurah Suarbawa M. Zully Amrul Hadi Made Yuliara Maghfirottul Iffah Mega Wahyu N. L. P. Trisnawati Nabilla Fatimah Nathaniel Marcellino Nengah Sandi NEVIATY PUTRI ZAMANI Ni Kadek Ayu Asari Dewi Ni Kadek Nova Anggarani Ni Komang Tri Suandayani Ni Komang Tri Suandayani Ni Komang Tri Suandayani Ni Luh Putu Trisnawati Ni Luh Putu Trisnawati NI LUH WIDYASARI Ni Made Purmita Sari Ni Nyoman Ratini Ni Nyoman Rupiasih Ni Nyoman, Ratini Ni Putu Aprillia Artanti Phalosa Ni Putu Pande Anita Yulianti Ni Putu Winiayu Veramika Ni Putu Yuni Nurmalasari Ni Putu Yuni Nurmalasari Ni Wayan Ekayani Nurfaizah Nurfaizah Nyoman Wendri Paranditayana, I Nyoman Poniman, S. Pranditayana, I Nyoman Prayuda, I Made Ardi Putu Gede Agus Krisna Yogantara Putu Suardana Ramadan Purnama, Muhammad Mada Retianingsih Oeta Ulan Romadhon Ilham Imani Rozi Irhas Rozi Irhas Rozi Irhas Rozi Irhas Rozi Irhas Rozy Irhaz Sanjaya Natadiredja Sari, Kamelin Diah Satriya Wibawa, I Made Setiono, Made Budi Suandayani, Ni Komang Tri Sudarsan, I Wayan Balik Sudarsana, I Wayan Balik Sukarasa, I Ketut Sylvia Ariska Susanti Titik Purwanti Tjahyo Baskoro, Winardi Trisnawati, Ni Luh Putu Wayan Balik Sudarsana Wayan Balik Sudarsana Wayan Balik Sudarsana Wayan Balik Sudarsana Widiana, I Komang Widianingsih, Ni Kadek Indah Widya Karulina Imanda Muhamad Winer Johan Bora Yohana Dian Savitri Yuli Asri Yuliara, I Made Zofi Dwi Prihatini