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All Journal Medicinus : Jurnal Kedokteran Indonesian Journal of Cancer
Mira Yuniarti
Department of Radiology, Siloam Hospital Lippo Village, Tangerang, Banten
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Public Health

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Myocardial Infiltration in Primary Mediastinal B-Cell Lymphoma Detected by Cardiac Magnetic Resonance Imaging Sutedjo, Verawati; Soewondo, Widiastuti; Yuniarti, Mira; Tenggara, Jeffry Beta; Erawati, Dini Rachma
Indonesian Journal of Cancer Vol 17, No 4 (2023): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i4.966

Abstract

Introduction: Cardiac involvement, particularly myocardial infiltration in primary mediastinal lymphoma, is a rare occurrence with an incidence of only 9% in known cases of primary malignancy. Neoplasm infiltration into the myocardium manifests through direct invasion, hematogenous spread, transvenous invasion through the great veins, or lymphangitic spreading in the mediastinal. Myocardial infiltration in lymphoma presents a grim prognosis and its treatment may be associated with specific risks, such as myocardial rupture. Various imaging modalities may detect cardiac involvement, with cardiac magnetic resonance (CMR) imaging considered the gold standard. CMR enables clear delineation of myocardial infiltration, making it valuable for local staging, pretreatment planning, and evaluating treatment response. Case Presentation: : A 37-year-old woman patient was diagnosed with primary mediastinal large B-cell lymphoma. Mild chest discomfort and shortness of breath were observed 3 months before hospital admission. A thorax CT scan showed a heterogeneous contrast-enhancing mass with a central necrotic area in the anterior mediastinum. Following thoracotomy and tumor debulking, the patient complained of severe crushing chest pain radiating to her back, accompanied by new T wave inversion on ECG and elevated cardiac troponin levels a week after surgery. Coronary angiogram results showed a normal coronary artery. Subsequent cardiac MRI showed tumor infiltration into the anterior pericardial space, as well as the myocardium of the left and right ventricles. Chemotherapy was promptly initiated, resulting in a gradual improvement of symptoms. Conclusions: In this study, we discuss the use of 3D-CRT in the re-irradiation of NPC with its limitation on obtaining optimum dose sculpture compared to more sophisticated and widely spread modalities like IMRT. However, with careful planning, we can still obtain optimum tumor dose, minimize OAR dose, and subsequently late toxicities that come after. We hope that this study can bring hope to centers with limited facilities, and we suggest further studies on reirradiation, especially in OAR dose tolerance guidelines. 
Diagnostic Accuracy of Coronary Artery Calcium Scoring in Detecting Significant Coronary Artery Stenosis Compared with Invasive Coronary Angiography Erico, Adelbertus; Muljadi, Rusli; Yuniarti, Mira; Pardede, Ingrid Maria; Kurniawan, Andree; Jorizal, Patricia
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10757

Abstract

Background: Coronary artery disease (CAD) remains a leading cause of mortality, emphasizing the importance of early non-invasive diagnostic strategies. This study evaluated the diagnostic accuracy of coronary artery calcium scoring (CACS) in detecting significant coronary stenosis, using invasive angiography as the reference standard.   Methods: Sixty-three patients who underwent both CACS and quantitative coronary angiography were retrospectively analyzed. The mean total CACS was 684.1 ± 1030.8, and significant stenosis (≥70%) was most prevalent in the left anterior descending artery (92.1%).   Result: Spearman’s analysis revealed positive correlations between CACS and angiographic stenosis in the right coronary artery (ρ = 0.338, p = 0.007), left anterior descending artery (ρ = 0.492, p = 0.001), and left circumflex artery (ρ = 0.314, p = 0.012). Receiver operating characteristic (ROC) analysis demonstrated moderate-to-good diagnostic performance, with area under the curve (AUC) values of 0.699 for RCA, 0.769 for LAD, and 0.690 for LCX.   Conclusions: These findings indicate that CACS can serve as a reliable, low-cost, and non-invasive modality for preliminary screening and risk stratification of CAD, particularly in identifying patients who may benefit from invasive coronary angiography.
Association Between Gender, Coronary Artery Dominance and Severity of Coronary Artery Stenosis on Computed Tomography Angiography Kurniawan, Yohanes Chandra; Muljadi, Rusli; Koesbandono; Lukito, Antonia Anna; Lugito, Nata Pratama Hardjo; Yuniarti, Mira
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10780

Abstract

Background: Coronary artery disease (CAD) is one of the leading causes of death worldwide. Several preliminary studies suggest that certain dominance patterns may be associated with the distribution and severity of stenosis, influencing the risk of cardiac complications and interventional strategies. However, the relationship of gender specific between coronary artery dominance patterns and the severity of stenosis remains poorly understood. This study designed to evaluate the relationship between gender specific, coronary artery dominance, and severity of coronary artery stenosis, number of stenosis vessels, stenosis location, and calcium score on CCTA examination.   Methods: A retrospective cross-sectional study with consecutive non-probability sampling was conducted over a one-year period with 1115 patients who underwent CCTA were analysed using the Chi-square test, Fisher’s exact test, and T-test according to the type of data.   Result: The result showed a strong association was found between non-right dominant coronary artery (non-RDCA) in females and significant coronary stenosis (p=0.009), with the most strongly associated location being the LCX (p=0.017).   Conclusions: These findings suggest the presence of gender- and dominance-specific patterns in coronary artery disease (CAD), warranting further investigation using prospective study designs and larger sample sizes.
Co-Authors Anak Agung Istri Sri Wiadnyani Andree Kurniawan Antonia Anna Lukito Erawati, Dini Rachma Erico, Adelbertus Jeffry Beta Tenggara Jorizal, Patricia Julius July Koesbandono Kurniawan, Yohanes Chandra Nata Pratama Hardjo Lugito Pardede, Ingrid Maria Priscilla Muliantara Rusli Muljadi, Rusli Soewondo, Widiastuti Sutedjo, Verawati