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Studi Kasus Pemeriksaan MSCT Urografi Multiphase dengan Klinis Tumor Ginjal Ratna Tri Rahayu; Nanang Sulaksono; Andrey Nino Kurniawan
Jurnal Imejing Diagnostik (JImeD) Vol 9, No 2: JULY 2023
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v9i2.10402

Background: The procedure for examining multi-slice computed tomography (MSCT) multiphase urography with clinical kidney tumors in the Radiology Installation of the Banyumas General Hospital differs from the literature in the use of scans in the corticomedullary phase and the post-contrast scanning phase. This study aims to determine the procedure for MSCT Urography Multiphase examination with clinical kidney tumors, to find out the reasons for using a scan of the corticomedullary phase area from the diaphragm to the pubic symphysis and to find out the reasons for using four phases of post-contrast scanning.Methods: This type of research is qualitative research with a case study approach. Data was collected at the radiology installation at the Banyumas Hospital from January to May 2023, the study respondents consisted of three radiographers, one radiologist, one sending doctor and one radiology nurse. Methods of data collection by observation, in-depth interviews, documentation. Data analysis was carried out through the stages of data collection, data reduction, data presentation and drawing conclusions.Results: MSCT Urography Multiphase examination procedure with clinical kidney tumors in the radiology installation of Banyumas Hospital includes, the patient's supine feet first position, scanning area from the diaphragm to the symphysis pubis, using 50 ml of contrast media with 40 ml of saline flush. Scanning technique by taking the pre-contrast phase, corticomedullary phase, nephrography phase, equilibrium phase and delay phase. Scan the area of the corticomedullary phase from the diaphragm to the symphysis pubis to to simplify the scanning process because the tool protocol has already made full abdominal scan area settings and to evaluate the pattern of abdominal organ enhancement if there is a metastatic urothelial lesion other than the kidney. The use of four phases of post-contrast scanning is because the goals and functions of each scanning phase are different so that the maximum diagnostic information is obtained.Conclusions: The MSCT Urography Multiphase examination procedure with clinical kidney tumors in the radiology installation of Banyumas can provide optimal diagnostic information.

MSCT Thoracolumbal Kontras pada Suspek Metastasis Tulang Belakang: Studi Kasus di Rumah Sakit Hermina Pandanaran Semarang Margarita Puspitawati; Dwi Rochmayanti; Yeti Kartikasari; Nanang Sulaksono; Sudiyono Sudiyono
Jurnal Imejing Diagnostik (JImeD) Vol 9, No 1: JANUARY 2023
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v9i1.9242

Background: MSCT is a routine imaging modality for detecting bone metastases. The use of 1.25 mm slice thickness reconstruction on Thoracolumbar MSCT examination at Hermina Pandanaran Hospital is different from preliminary studies. This study aims to determine MSCT Thoracolumbar contrast with 1.25 mm slice thickness and 3D reconstruction to produce information on anatomical images in suspected cases of spinal metastases. Methods: This research was qualitative with a case study approach. The respondents were 3 radiographers, 2 radiologists, and 1 referring doctor. Data collection by observation, interviews, and document studies. Processing and data analysis used open coding and analysis to obtain conclusions. Results: The examination procedure was carried out by preparing the patient to fast for 6 hours before the examination, checking the results of ureum creatinine, filling out the informed consent and doing a skin test. Contrast media as much as 1.1-1.2 ml/kg per patient's body weight plus saline half of the amount of contrast, flow rate 2.5-3 mL/s, scan delay 25 s. DFOV 25-35cm, ASIR 40%. Reconstruction of slice thickness 1.25 mm to get more detailed results so that it could produce informative images that evaluated the spine and soft tissue. MPR and 3D reconstruction so that the image looked real bone and could be viewed 360ᵒ. Conclusions: The resulting slice thickness of 1.25mm and 3D reconstruction produced anatomical image information that could visualize bone to see destructive lytic lesions due to metastases, and visualize soft tissue such as paravertebral masses or discs.

Optimasi Informasi Diagnostik Citra Axial MRI Brain antara Sekuen SWI dan T2 FLASH 2D pada Kasus Tumor Otak Siti Nur Farida; Nanang Sulaksono; Ary Kurniawati
Jurnal Imejing Diagnostik (JImeD) Vol 10, No 2 (2024): JULI 2024
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v10i2.11583

Background: Pulse gradient echo sequences use varying RF excitation pulses and with NMV flips through various angles (not just 90°). Gradient echo has a sensitive susceptibility effect in detecting the presence of blood products (hemorrhage) and calcifications in brain tumors. The SWI and T2 FLASH 2D sequences are part of the pulse sequence gradient echo, where the SWI sequence is a 3D velocity compensated gradient echo and the T2 FLASH 2D sequence is a 2D multi-slice gradient echo. This study aims to determine the differences in axial image diagnostic information and determine the most optimal axial image diagnostic information in MRI brain examinations between SWI and T2 FLASH 2D sequences in brain tumor cases.Methods: This type of research is quantitative with an experimental approach. Data was taken in March 2024 at the Radiology Installation of RSUP Dr. Sardjito Yogyakarta. The sample in this study was 10 patients with brain tumor cases. An assessment was carried out by 2 respondents to assess the criteria for brain tumors. The assessment data from respondents was tested using the Cohen's kappa test to assess reliability between respondents and the Wilcoxon test to determine the level of difference in axial image diagnostic information, then the mean rank was used to determine sequences with better diagnostic image information.Results: The results of the study show that there is a difference in the diagnostic information of axial images on MRI brain examination between SWI and T2 FLASH 2D sequences in tumor cases with a p-value of 0.014. The significant difference is due to the susceptibility effect in both sequences. Based on the Wilcoxon test, the SWI sequence is the most optimal sequence in displaying diagnostic information with a mean rank value of 4.Conclusions: There is a difference of axial image diagnostic information between SWI and T2 FLASH 2D sequence in Brain MRI with brain tumors cases, and SWI sequence produces the most optimal axial image diagnostic information in MRI brain with brain tumor cases.

Penerapan Artificial Intelligence dalam Mendeteksi Batu Ginjal secara Otomatis pada Citra CT Scan Nanang Sulaksono; Ary Kurniawati
Jurnal Imejing Diagnostik (JImeD) Vol 10, No 1: JANUARY 2024
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v10i1.11072

Background: Kidney stones are a clinical condition with the presence of stones along the urinary tract of varying sizes. The aim of this research is the need for a system to automatically detect kidney stones so that it can help radiologists in diagnosing kidney stones accurately, effectively and efficiently, and patients can immediately undergo further action to cure kidney stones.Methods: The difference in research carried out by researchers is the use of artificial intelligence which uses deep learning with a convolutional neural network (CNN) algorithm. This research uses images obtained from CT scan results from public data (Kaggle) and primary hospital data. The number of images used in the Augmentation training data was 2338 normal images and 2390 kidney stone images. The augmentation testing data used 540 normal images and 446 kidney stone images. The research also involved experts, namely radiology specialists, in determining images with abnormal and normal stone tones.Results: research obtained from CT Scan images of kidney stones with augmentation and original using public data/Kaggle images, obtained using augmentation obtained a high accuracy value of 99.69%. Meanwhile, in testing data using primary/hospital data images, augmented data obtained accuracy values that were still low at 45.43% and 45.23%, respectively.Conclusions: The use of deep learning with the CNN model in training data augmentation obtained high accuracy values, however in testing data using hospital CT scan images the accuracy value was still low, but it was able to recognize images of kidney stones, so it could help in automatically diagnosing kidney stones. For future work could involve refining the model to handle variations in hospital data or exploring additional features to improve generalizability.

Utilization of convolutional neural network in image interpretation techniques for detecting kidney disease Sulaksono, Nanang; Adi, Kusworo; Isnanto, Rizal
IAES International Journal of Artificial Intelligence (IJ-AI) Vol 14, No 1: February 2025
Publisher : Institute of Advanced Engineering and Science

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijai.v14.i1.pp602-613

This research is conducted with deep learning for kidney stone disease detection including cysts, stones, normal, and tumors using axial computerized tomography (CT) scan images. The author uses augmentation, generative adversarial networks (GANs), original, and synthetic minority over-sampling technique (SMOTE) to classify kidney disease (cyst, stone, normal, and tumor). This study uses the public dataset nazmul0087 and primary data/data from the hospital, using convolutional neural network (CNN) models, namely augmentation, GANs, original, and SMOTE by training and testing. The results of the accuracy value of the training model (dataset nazmul0087) in the detection of kidney cysts, stones, tumors, and normal. The results of augmentation value are 99.93%, GANs 100%, original 100%, and SMOTE 99.93%. In the results of the training model, a very high accuracy value is obtained, with perfect results. The testing model's accuracy value in detecting kidney cysts, stones, tumors, and normal kidney tissue in the original dataset and hospital data. The results of augmentation value are 11.48%, GANs 17.96%, original 21.76%, and SMOTE 20.41%. In the results of the training model, the highest accuracy value is obtained in the original model. For the testing model to automatically diagnose kidney illness and obtain a high accuracy value, which can enhance patient outcomes and save health care costs, we advise using it in conjunction with the original model.

Prosedur Pemeriksaan MRI Cruris dengan Kontras pada Kasus Tumor Ambarwati, Seli; Sulaksono, Nanang; Jannah, Marichatul
Jurnal Imejing Diagnostik (JImeD) Vol 11, No 1 (2025): JANUARY 2025
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v1i1.12436

Background: This study examines the MRI Cruris contrast examination procedure for tumor cases at Dr. Moewardi Hospital. The hospital's MRI protocol includes sequences such as 3-plane localizer, Sag T1, Sag T2, Ax T1, Ax T2 STIR, Coronal T1, Coronal PD FS, Coronal T2* MERGE, 3D Coronal TRICKS, and post-contrast sequences Sag T1+C, Coronal T1+C, and Ax T1+C. The study aims to analyze the MRI Cruris contrast procedure, the rationale for using 5 ml contrast, and the importance of the Coronal 3D TRICKS sequence.Methods: A qualitative research method with a case study approach was used, involving observation, interviews, and documentation. The data was analyzed and presented in quotations to conclude.Result and Discussion: The MRI procedure begins with patient preparation, including laboratory tests for urea and creatinine levels, fasting for 4–6 hours, and filling out informed consent. Patients are positioned supine with feet first, and an air coil is placed on the leg. The use of 5 ml contrast enhances image quality, improves tumor detection, evaluates blood vessels, shows lesions, and determines tumor location and spread. The Coronal 3D TRICKS sequence provides clear MRA angiography, enabling better visualization of feeding arteries and rapid imaging of major blood vessels within 10 seconds.Conclusion: In conclusion, the MRI Cruris contrast protocol at Dr. Moewardi Hospital ensures high-quality imaging for tumor detection and diagnosis. The 5 ml contrast dose effectively enhances MRI images, and the Coronal 3D TRICKS sequence plays a crucial role in evaluating vascular structures.

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

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.

MSCT Thoracolumbal Kontras pada Suspek Metastasis Tulang Belakang: Studi Kasus di Rumah Sakit Hermina Pandanaran Semarang Puspitawati, Margarita; Rochmayanti, Dwi; Kartikasari, Yeti; Sulaksono, Nanang; Sudiyono, Sudiyono
Jurnal Imejing Diagnostik (JImeD) Vol. 9 No. 1: JANUARY 2023
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v9i1.9242

Background: MSCT is a routine imaging modality for detecting bone metastases. The use of 1.25 mm slice thickness reconstruction on Thoracolumbar MSCT examination at Hermina Pandanaran Hospital is different from preliminary studies. This study aims to determine MSCT Thoracolumbar contrast with 1.25 mm slice thickness and 3D reconstruction to produce information on anatomical images in suspected cases of spinal metastases.Â Methods: This research was qualitative with a case study approach. The respondents were 3 radiographers, 2 radiologists, and 1 referring doctor. Data collection by observation, interviews, and document studies. Processing and data analysis used open coding and analysis to obtain conclusions.Â Results: The examination procedure was carried out by preparing the patient to fast for 6 hours before the examination, checking the results of ureum creatinine, filling out the informed consent and doing a skin test. Contrast media as much as 1.1-1.2 ml/kg per patient's body weight plus saline half of the amount of contrast, flow rate 2.5-3 mL/s, scan delay 25 s. DFOV 25-35cm, ASIR 40%. Reconstruction of slice thickness 1.25 mm to get more detailed results so that it could produce informative images that evaluated the spine and soft tissue. MPR and 3D reconstruction so that the image looked real bone and could be viewed 360áµ’.Â Conclusions: The resulting slice thickness of 1.25mm and 3D reconstruction produced anatomical image information that could visualize bone to see destructive lytic lesions due to metastases, and visualize soft tissue such as paravertebral masses or discs.Â

Penerapan Artificial Intelligence dalam Mendeteksi Batu Ginjal secara Otomatis pada Citra CT Scan Sulaksono, Nanang; Kurniawati, Ary
Jurnal Imejing Diagnostik (JImeD) Vol. 10 No. 1: JANUARY 2024
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v10i1.11072

Background: Kidney stones are a clinical condition with the presence of stones along the urinary tract of varying sizes. The aim of this research is the need for a system to automatically detect kidney stones so that it can help radiologists in diagnosing kidney stones accurately, effectively and efficiently, and patients can immediately undergo further action to cure kidney stones.Methods: The difference in research carried out by researchers is the use of artificial intelligence which uses deep learning with a convolutional neural network (CNN) algorithm. This research uses images obtained from CT scan results from public data (Kaggle) and primary hospital data. The number of images used in the Augmentation training data was 2338 normal images and 2390 kidney stone images. The augmentation testing data used 540 normal images and 446 kidney stone images. The research also involved experts, namely radiology specialists, in determining images with abnormal and normal stone tones.Results: research obtained from CT Scan images of kidney stones with augmentation and original using public data/Kaggle images, obtained using augmentation obtained a high accuracy value of 99.69%. Meanwhile, in testing data using primary/hospital data images, augmented data obtained accuracy values that were still low at 45.43% and 45.23%, respectively.Conclusions: The use of deep learning with the CNN model in training data augmentation obtained high accuracy values, however in testing data using hospital CT scan images the accuracy value was still low, but it was able to recognize images of kidney stones, so it could help in automatically diagnosing kidney stones. For future work could involve refining the model to handle variations in hospital data or exploring additional features to improve generalizability.

Optimasi Informasi Diagnostik Citra Axial MRI Brain antara Sekuen SWI dan T2 FLASH 2D pada Kasus Tumor Otak Farida, Siti Nur; Sulaksono, Nanang; Kurniawati, Ary
Jurnal Imejing Diagnostik (JImeD) Vol. 10 No. 2 (2024): JULI 2024
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jimed.v10i2.11583

Background: Pulse gradient echo sequences use varying RF excitation pulses and with NMV flips through various angles (not just 90Â°). Gradient echo has a sensitive susceptibility effect in detecting the presence of blood products (hemorrhage) and calcifications in brain tumors. The SWI and T2 FLASH 2D sequences are part of the pulse sequence gradient echo, where the SWI sequence is a 3D velocity compensated gradient echo and the T2 FLASH 2D sequence is a 2D multi-slice gradient echo. This study aims to determine the differences in axial image diagnostic information and determine the most optimal axial image diagnostic information in MRI brain examinations between SWI and T2 FLASH 2D sequences in brain tumor cases.Methods: This type of research is quantitative with an experimental approach. Data was taken in March 2024 at the Radiology Installation of RSUP Dr. Sardjito Yogyakarta. The sample in this study was 10 patients with brain tumor cases. An assessment was carried out by 2 respondents to assess the criteria for brain tumors. The assessment data from respondents was tested using the Cohen's kappa test to assess reliability between respondents and the Wilcoxon test to determine the level of difference in axial image diagnostic information, then the mean rank was used to determine sequences with better diagnostic image information.Results: The results of the study show that there is a difference in the diagnostic information of axial images on MRI brain examination between SWI and T2 FLASH 2D sequences in tumor cases with a p-value of 0.014. The significant difference is due to the susceptibility effect in both sequences. Based on the Wilcoxon test, the SWI sequence is the most optimal sequence in displaying diagnostic information with a mean rank value of 4.Conclusions: There is a difference of axial image diagnostic information between SWI and T2 FLASH 2D sequence in Brain MRI with brain tumors cases, and SWI sequence produces the most optimal axial image diagnostic information in MRI brain with brain tumor cases.

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