Nanang Sulaksono, Nanang
Technic of Radiodiagnostic and Radiotherapy Department, Polytechnic Health Ministry of Semarang

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Informasi Citra Anatomi CT Scan Kepala pada Kasus Stroke Iskemik dengan Variasi Windowing Putro, Wahyu Murti Cahyo; Sulaksono, Nanang; Wibowo, Ardi Soesilo
Jurnal Imejing Diagnostik (JImeD) Vol. 11 No. 2 (2025): JULY 2025
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v11i2.13190

Abstract

Background: Ischemic stroke is a critical condition detectable through head CT scans, where windowing techniques significantly enhance brain tissue visualization. At Bethesda Hospital Yogyakarta, differing windowing protocols are used in the Emergency and Main Radiology Departments, yet no standardized stroke-specific window has been established. This study aims to identify the differences in anatomical information in head CT scans with various windowing settings and to determine the most optimal windowing protocol.Methods: This research is a quantitative-experimental study conducted at Bethesda Hospital Yogyakarta involving 10 patients with ischemic stroke, using variations of windowing settings: WW 120 HU WL 60 HU, WW 100 HU WL 35 HU, and WW 40 HU WL 40 HU. The image results were evaluated by two respondents based on the anatomical information of brain parenchyma, insular cortex, internal capsule, left and right cerebral hemispheres, and brain sulci. The data analysis was performed using the Friedman statistical test.Results: The results of the study showed that the WW 100 HU WL 35 HU setting provided the most informative anatomical visualization across all evaluated brain structures. In contrast, WW 120 HU WL 60 HU was the least informative for the brain parenchyma and insular cortex, while WW 40 HU WL 40 HU offered moderate clarity for most structures but was suboptimal for the brain parenchyma. These differences were confirmed by the Friedman test, with a p-value < 0.05.Conclusions: There were differences in anatomical information across the various windowing settings in head CT scan examinations for ischemic stroke cases. In addition, the highest overall and individual anatomical mean rank was found in the WW 100 HU WL 35 HU windowing setting, with a value of 2.95.
Efektivitas Software Organ Dose Modulation (ODM) dalam Penurunan Dosis Radiasi pada CT Thorax Fatmayanti, Halinda; Sulaksono, Nanang; Kurniawati, Ary
Jurnal Imejing Diagnostik (JImeD) Vol. 12 No. 1 (2026): JANUARY 2026
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v12i1.14448

Abstract

Background: CT Scanning is a diagnostic examination modality that uses radiation to obtain detailed cross-sectional images of the human body. CT thorax is a frequently performed examination to evaluate lung parenchyma, airways, and mediastinal structures. This increases collective radiation exposure, thereby increasing long-term biological effects, especially on radiosensitive organs in the thorax, such as the mammary glands, thyroid, lungs, and spinal cord. One strategy to optimize dose exposure to radiosensitive organs is to use Organ Dose Modulation (ODM) software. ODM is a CT feature that can reduce radiation exposure to radiosensitive organs. This study aims to evaluate the effectiveness of ODM in reducing radiation dose in CT thorax examinations and its impact on image quality. Methods: This experimental study using a quantitative approach was conducted by Scanning a torso phantom from August to October 2025 at Indriati Solo Baru General Hospital. Thoracic Scanning was performed with two conditions: ODM OFF and ODM ON. Radiation exposure measurements in radiosensitive areas were performed by placing TLDs over the thyroid, mammary glands, lungs, and vertebrae (spinal cord), with each measurement repeated twice. Image quality was then assessed using SNR and CNR measurements with three repeated measurements. The resulting data were analyzed descriptively and analytically to compare dose distribution and image quality when the ODM was turned off and on. Results: TLD measurements demonstrated dose redistribution when the ODM was activated. Comparison of the average dose showed a decrease in anterior radiosensitive organs, with a 2.59% decrease in the thyroid and a 16.71% decrease in the mammary glands. Conversely, there was an increase in dose in the posterior and lateral regions, with a 45.05% increase in the vertebrae and a 5.05% increase in the lungs. Image quality analysis revealed a 14.76% increase in SNR and a 28.30% increase in CNR when the ODM was activated. Conclusions: This study demonstrates that the ODM not only reduces radiation dose to anterior radiosensitive organs but also improves image quality.