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All Journal Paediatrica Indonesiana Journal Of Vocational Health Studies Callosum Neurology Journal : Jurnal Berkala Neurologi Bali Majalah Biomorfologi (Biomorphology Journal) Indian Journal of Forensic Medicine & Toxicology AKSONA

Sri Andreani Utomo, Sri Andreani

Department Of Radiology, Faculty Of Medicine Universitas Airlangga; Dr. Soetomo General Academic Hospital Surabaya, Indonesia; Asian Musculoskeletal Society

Author-ID : 622855

Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience Public Health

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Articles

Characteristics of Apparent Diffusion Coefficient and Time Intensity Curve in AdvancedMagnetic Resonance Imaging of Malignant Soft Tissue Tumors Agus Jati Waluyo; Sri Andreani Utomo; Rosy Setiawat
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 3 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i3.15592

Malignant soft tissue tumors are usually identified and characterized by conventional magnetic resonance imaging (MRI) due to its high resolution on soft tissues. However,combinationof advanced MRI and conventional MRI increases the accuracy. This study was conducted to assess the characteristics of apparent diffusion coefficient(ADC) and time intensity curve (TIC) in dynamic contrast-enhanced MRI (DCE-MRI) in malignant soft tissue tumors. A cross-sectional study was conducted inDr. Soetomo Hospital, Surabaya, Indonesia. Demographic and clinical data, theclassification of malignant soft tissue tumor, histopathological examination results, ADC value, and TIC of DCE-MRI were collected.Between 1st January2018 and 30thAugust 2020, 30 malignant soft tissue tumors were included of which the most common malignantsoft tissue tumorsoccurred in those who were older than 50 year (30.0%) and located in the femur (33.3%). The most common tumor was synovial sarcoma (23.3%) and undifferentiated pleiomorphic sarcoma (20.0%). Type 4 and 3 of TIC were found in 92.0% and 8.0%, respectively. The overall mean of ADC and steepest slope were 0.84x10-3±0.14x10-3mm2/sand 15.8%±19.9%, respectively. The highest and the lowest mean ADCwas observed in squamous cell carcinoma and squamous cell carcinoma, and malignant peripheral nerve sheath tumor (MPNST), respectively. In contrast, the highest and the lowest steepest slopewas found in MPNST and squamous cell carcinomawith 75.43% and 2.45%, respectively.In conclusion, information of TICparameters such as ADCvalue and steepest slope might potentially be used in determining the histopathologic types of malignant soft tissue tumors.

Management of Lowe syndrome: a case report Risky Vitria Prasetyo; Heru Setiawan; Ninik Asmaningsih Soemyarso; Mohammad Sjaifullah Noer; Irwanto Irwanto; Prastiya Indra Gunawan; Rozalina Loebis; Sri Andreani Utomo; Ni Wayan Tirthaningsih
Paediatrica Indonesiana Vol 55 No 3 (2015): May 2015
Publisher : Indonesian Pediatric Society

Lowe syndrome (the oculocerebrorenal syndrome of Lowe, OCRL) is a multisystem disorder characterized by anomalies affecting the eyes, nervous system and kidneys.1-3 The disorder was first recognized by Lowe et al. in 1952, and described as a unique syndrome with organic aciduria, decreased renal ammonia production, hydrophthalmos, and mental retardation. In 1954, renal Fanconi syndrome was recognized as being associated with Lowe syndrome and in 1965, a recessive X-linked pattern of inheritance was determined.2,4 Lowe syndrome is a very rare disease, with an estimated prevalence in the general population of 1 in 500,000. According to the Lowe Syndrome Association (LSA) in the USA, the estimated prevalence is between 1 and 10 affected males in 1,000,000 people, with 190 living in the year 2000. The Italian Association of Lowe Syndrome estimated that there were 34 Lowe syndrome patients (33 boys and one girl) living in Italy in the year 2005.2,4,5 It almost exclusively affects males.6 Physicians may not be familiar with Lowe syndrome due to its rarity.4

DIFFERENCES OF TEMOZOLAMIDE RESPONSE IN GLIOBLASTOMA MULTIFORME: REPORT OF TWO CASES Djohan Ardiansyah; Vita Kusuma Rahmawati; Sri Andreani Utomo
Callosum Neurology Vol 3 No 3 (2020): Callosum Neurology Journal
Publisher : The Indonesia Neurological Association Branch of Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29342/cnj.v3i3.89

Background: Glioblastoma multiforme (GBM) is about 20% of primary adult brain neoplasms which has poor prognosis; life expectancy is no more than 12 months after the diagnosis. Temozolomide (TMZ) has become GBM standard therapy, combined with the surgery and radio-chemotherapy. Evaluation is important since its relation with the continuity or termination of therapy. Several studies are improving to measure therapy response of GBM. Response Assessment in Neuro-Oncology (RANO) criteria which is published in 2010, became a major criterias to evaluate TMZ response in patients with GBM. This criteria combines clinical manifestation, steroid therapy, and brain magnetic resonance imaging (MRI). Case: We report two GBM cases with standard management. Two women in productive ages and specific clinical manifestations, diagnosed with GBM in left temporal lobes. A 24-year-old woman showed complete response; while a-41-year old one showed progressive response. Discussion: We analyze TMZ response based on RANO criteria. Prognostic factors that differentiate TMZ response in both cases were presence of comorbidity, intratumoral hemorrhage on MRI, and surgery initiation in early diagnosis. Conclusion: Based on RANO criteria and prognostic factors which support TMZ response, the role of adjuvant TMZ become important in standard management of GBM. Keywords: Glioblastoma Multiforme, Response Assessment in Neuro-Oncology, Temozolomide.

Diffusion Weighted Imaging (DWI) Classification and Apparent Diffusion Coefficient (ADC) Value Tendency Based on Cerebral Glioma Grading in Patients at Dr. Soetomo General Academic Hospital in 2016-2020 Komang Wahyu Kurniawan; Sri Andreani Utomo; Joni Wahyuhadi
AKSONA Vol. 3 No. 1 (2023): JANUARY 2023
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar

Highlight: Many studies conclude that the prognosis of gliomas can be determined using the DWI sequence and ADC value on MRI The correlation between DWI and ADC values with glioma grading is related to tumor cellularity, nuclear-cytoplasmic ratio, and extracellular space, which affect the movement of water molecules. ABSTRACT Introduction: Glioma grading is crucial to know its prognosis. Magnetic resonance imaging (MRI) is used as a preoperative examination that contains diffusion-weighted imaging (DWI) sequences confirmed by an apparent diffusion coefficient (ADC) value that helps assess tissue based on water diffusion. Objective: To prove the relationship between DWI and ADC values with cerebral glioma grading in patients at Dr. Soetomo General Academic Hospital in 2016—2020. Methods: This retrospective study collected medical records and MRI files in DICOM (Digital Imaging and Communications in Medicine) format. Gender, age, tumor histopathology, and glioma grading were collected. DWI and ADC values were obtained using the RadiAnt DICOM Viewer application. The data were analyzed using descriptive and analytical statistics. The chi-square test was used to analyze the relationship of DWI with glioma grading, and the spearman rank test was used to analyze the relationship of ADC value with glioma grading. Results: The majority of 35 patients were male (54.3%), aged 31–40 years old (22.9%), and the most common histopathology was glioblastoma (37.1%), WHO grade IV. On DWI, most low-grade glioma (LGG) patients showed unrestricted diffusion, and most high-grade glioma (HGG) patients showed restricted diffusion. The ADC value of HGG was lower than the ADC value of LGG. Statistical tests showed a relationship between DWI and glioma grading (p<0.05) and a relationship between the ADC value and glioma grading (p<0.05). Conclusion: There was a relationship between DWI and ADC with glioma grading in Dr. Soetomo General Academic Hospital patients for the period 2016—2020

EFFECT OF MODIC CHANGE ON CLINICAL OUTCOME OF CERVICAL DISC HERNIATION PATIENTS UNDERGOING ANTERIOR CERVICAL DISCECTOMY AND FUSION Wibowo, Caesaroy Afif; Sri Andreani Utomo; Muhammad Faris; Tsabita Hadid
Majalah Biomorfologi Vol. 33 No. 2 (2023): MAJALAH BIOMORFOLOGI
Publisher : Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mbiom.v33i2.2023.100-108

Highlights The presence of preoperative Modic changes tends not to affect clinical outcomes after ACDF due to degenerative pathology, including disc herniation. Preoperative Modic changes are correlated with a worse preoperative picture. Abstract Background: Modic Change (MC) is a phenomenon that can be found in Magnetic Resonance Imaging (MRI) of patients with degenerative spinal diseases and in the cervical region. The effect of Modic change on the clinical outcome of postoperative patients has not been fully established. Anterior Cervical Discectomy and Fusion (ACDF) is a procedure that has become the gold standard in treating cervical disc herniation because it is able to eliminate pathological lesions and prevent the recurrence of nerve compression. Objective: This study aimed to determine the effect of MC on the clinical outcome of patients undergoing ACDF therapy due to degenerative disc pathology, including cervical disc herniation. Material and Method: This was a systematic review using filtered literature based on PICOs. The variables examined in this study were "modic change", "ACDF", and "clinical outcome". Data were collected from three databases, which were then screened based on eligibility criteria, assessed for study quality, and reviewed using a qualitative descriptive method. Result: A total of six articles published between 2017 and 2021 were included in this study. This study was an observational study with a retrospective cohort method. Preoperative Modic changes tend not to affect clinical outcomes after ACDF. Conclusion: The presence of preoperative Modic changes tends not to affect clinical outcomes after ACDF due to degenerative disc pathology, including disc herniation, but remains a risk factor for postoperative disability and provides a worse preoperative picture.

Profile of Meningioma Patients at Dr. Soetomo General Academic Hospital Valeryna, Natasha; Ardiansyah, Djohan; Susanto, Joni; Utomo, Sri Andreani
AKSONA Vol. 4 No. 2 (2024): JULY 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v4i2.53334

Highlight: Meningioma, the most common primary brain tumor, is typically found in women aged 40-49 years old. Meningiomas can show distinctive characteristics on clinical, radiological, and histopathological examinations. There were significant differences in histopathological grading between male and female patients, as well as between homogenous and heterogenous contrast enhancement. ABSTRACT Introduction: Meningioma is an intracranial extracranial tumor that arises from arachnoid cells. It is reported to be the most common primary brain tumor (39%). Meningioma is diagnosed based on clinical and radiological findings, but a definitive diagnosis requires histopathology examination. However, the clinical, radiological, and histopathological profile of meningioma is rarely studied in Indonesia. Objective: This study aimed to identify the clinical, radiological, and histopathological profile of meningioma patients at Dr. Soetomo General Academic Hospital Surabaya from 2017 to 2021. Methods: This was a retrospective observational study with a cross-sectional design using secondary data collected from electronic medical records at Dr. Soetomo General Academic Hospital Surabaya in 2017-2021. Results: A total of 256 patients were included in this study. The majority of the patients in this study were female (83.98%), aged 40-49 years old (43.36%), and mostly had the clinical symptom of headache (35.94%). Meningiomas were mostly WHO grade I (85.16%), with a transitional subtype (44.92). Based on the Kruskal-Wallis test, there were differences in histopathological grading between male and female patients (p = 0.000), as well as between homogenous and heterogenous tumor enhancement (p = 0.027). However, there were no differences in histopathological grading between the dural tail findings (p = 0.181) and hyperostosis findings (p = 0.135). Conclusion: Meningioma was found to be more common in females than in males, with the peak occurring in 40-49 years old. The most prevalent clinical symptom was headache, and convexity was the most common location for these tumors, most of which were larger than 3 cm. The majority of meningiomas were WHO grade I with transitional subtype.

EVALUATION COMPARISON IMAGE QUALITY OF BREATH HOLD (SSTSE) AND RESPIRATORY TRIGGERING (TSE) TECHNIQUE TO THE EXAMINATION OF MAGNETIC CHOLANGIOPANCREATOGRAPHY (MRCP) Suroiyah, Nikky Anis; Latifah, Risalatul; Utomo, Sri Andreani
Journal of Vocational Health Studies Vol. 1 No. 2 (2017): November 2017 | JOURNAL OF VOCATIONAL HEALTH STUDIES
Publisher : Faculty of Vocational Studies, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jvhs.V1.I2.2017.39-43

Background: Magnetic resonance cholangiopancreatography (MRCP) is MRI examination to visualize to visualize a disorder in part biliary or of the human bile. The artefact in the image MRCP is often happened due to the movement of respiratory system. Purpose: This study to compare the better image quality between Breath Hold (SSTSE) and Repiratory Triggering (TSE)techinques. Method: This study used observational analytic study with prospective approach. 16 samples were examined with two techniques SSTSE and TSE respectively in order to get 3D MRCP image. The Signal to Noise Ratio (SNR) and Contrast to Noise Ratio (CNR) is measured to evaluate the image quality. Result: The SSTSE technique only has a higher SNR in gallbladder meanwhile the TSE technique has a higher SNR in pancreatic duct. The higher CNR is got using TSE technique. Conclusion: The TSE showed the higher SNR in pancreatic duct and the higher CNR is got with SSTSE technique. The recommendation technique for evaluating pancreatic duct is respiratory triggering.

FRACTIONAL ANISOTROPY AND MEAN DIFFUSIVITY VALUE IN 2ND GRADE OF DEGENERATIVE CERVICAL CANAL STENOSIS Cendikiawan, Hans; Utomo, Sri Andreani
Journal of Vocational Health Studies Vol. 2 No. 3 (2019): March 2019 | JOURNAL OF VOCATIONAL HEALTH STUDIES
Publisher : Faculty of Vocational Studies, Universitas Airlangga

Background: By using T2 weighted image (T2WI) of Magnetic Resonance Imaging (MRI), a radiologist can classify degenerative cervical canal stenosis (DCCS) into three grade, but there is no correlation between stenosis classification with clinical symptoms. It means that radiologist need a new parameter to make an early detection for spinal cord injury (SCI). Purpose: Proving decrease of FA and increase of MD at the most proximal level of 2nd grade DCCS patient compared with C1-2. Method: Cervical MR examination with 15-direction DTI sequens was performed on twenty one patient with neurological signs and symptoms of 2nd grade DCCS. Apparent FA and MD maps were generated on axial plane. The FA and MD measurements in each individual were made at the most proximal level of 2nd grade DCCS and C1-2. Wilcoxon rank sump test was used to compare FA and paired t-test was used for MD. Result : There are significant differences for FA (p = 0,00) and MD (p = 0,00) at the most proximal level of 2nd grade DCCS compared with C1-2. Conclusion: This research shows that FA and MD value at DTI sequens can be used for SCI early detection at 2nd grade DCCS patient

ANALYSIS OF FRACTIONAL ANISOTROPY (FA) VALUES AND APPARENT DIFFUSION COEFFICIENT (ADC) VALUES IN ISCHEMIC STROKE DISEASES OF MRI GE 3 TESLA Mustofa, Ali; Sensusiati, Anggraini Dwi; Muhaimin, Muhaimin; Utomo, Sri Andreani; Latifah, Risalatul
Journal of Vocational Health Studies Vol. 2 No. 3 (2019): March 2019 | JOURNAL OF VOCATIONAL HEALTH STUDIES
Publisher : Faculty of Vocational Studies, Universitas Airlangga

Background: Diffusion Weighted Imaging and Diffusion Tensor Imaging is an advanced technique in MRI that shows the diffusion in brain of ischemic stroke disease. Diffusion Weighted Imaging (DWI) shows the lesions without gadolinium contrast agent and produce Apparent Diffusion Coefficient values. Whereas, Diffusion Tensor Imaging (DTI) shows connectivity's of central nervous system that cannot be seen by using conventional MRI. Diffusion Tensor Imaging produces Fractional Anisotropy values. Purpose:This study has aim to analyze the Apparent Diffusion Coefficient values and Fractional Anisotropy values in Stroke Ischemic disease. Method: Total samples used are 14 samples, consist of 7 (50%) man and 7 (50%) woman with ischemic stroke disease. Each sample deals by Diffusion Weighted Imaging and Diffusion Tensor Imaging sequences. The Region of Interest (ROI) is placed in ischemic stroke lesions and contra lateral side of lesions. Result: The result shows that 9 samples of brain tissue lesions located in the right side and 5 samples in the left side. Right lesions have the average ADC stroke: 0.001748; normal ADC: 0.000954; FA stroke: 0.144522; and normal FA: 0.426111. While, left lesions have the average ADC strokes 0.000979; normal ADC: 0.000835; FA stroke: 0.2556; and normal FA 0.4324. Conclusion: So, the conclusion of this study is Apparent Diffusion Coefficient (ADC) values in case of ischemic stroke can decreases or increases depend on the age of stroke. While, the Fractional Anisotropy (FA) values will decrease without being affected by age of stroke.

IMAGE COMPARISON ON T2 QTSE LUMBAL EXAMINATION USING GRAPPA TECHNIQUE WITH AND WITHOUT MAGNETIZATION TRANSFER CONTRAST IN DEGENERATIVE DISC DISEASE CASE Arief Apriliani, Karina Sandra; Utomo, Sri Andreani; Muhaimin; Muqmiroh, Lailatul
Journal of Vocational Health Studies Vol. 6 No. 1 (2022): July 2022 | JOURNAL OF VOCATIONAL HEALTH STUDIES
Publisher : Faculty of Vocational Studies, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jvhs.V6.I1.2022.9-16

Background: The description of Degenerative Disc Disease in MRI lumbar FSE sequence T2WI is seen as a decrease in signal intensity. Patients with cases of Degenerative Disc Disease experience severe low back pain and cannot lie supine for a long time, while MRI is very sensitive to movement. GRAPPA is a parallel imaging technique that can produce images with a fast scan time but is followed by a decreased Signal to Noise Ratio SNR value. This technique needs to be followed by setting other parameters to produce an optimal image, namely by applying Magnetization Transfer Contrast (MTC). Purpose: To compare the quality of image results on lumbar MRI examination of the sagittal T2 qTSE sequence in the case of Degenerative Disc Disease with and without MTC activation. Method: This research was conducted at the dr. Soedono Madiun from August to September 2020. A sample of 16 patients who met the inclusion criteria was taken during the study. The GRAPPA and GRAPPA+MTC technique imagery results on each sample were assessed for the image quality quantitatively based on the SNR and CNR values. Result: Based on the SNR value, the GRAPPA technique and MTC activation have a higher mean than the GRAPPA technique alone. Likewise, with the CNR value, the GRAPPA technique and MTC activation have a higher average than the GRAPPA technique alone. Conclusion: The GRAPPA technique and MTC activation can be applied in Lumbar MRI examination with cases of Degenerative Disc Disease, especially in uncooperative patients.

Co-Authors Abdul Hafid B Agus Jati Waluyo Ali Mustofa Ardiansyah, Djohan Arief Apriliani, Karina Sandra Budi Utomo Cendikiawan, Hans Endra Wibisono Harmawan Heru Setiawan Irwanto, Irwanto Joni Susanto, Joni Joni Wahyuhadi, Joni Komang Wahyu Kurniawan Kusumastuti, Kurnia Mohammad Sjaifullah Noer Muhaimin Muhaimin Muhaimin Muhammad Faris Muhammad Faris Muqmiroh, Lailatul Ni Wayan Tirthaningsih Nikky Anis Suroiyah, Nikky Anis Ninik Asmaningsih Soemyarso Prastiya Indra Gunawan Risalatul Latifah Risky Vitria Prasetyo Rosy Setiawat Rozalina Loebis, Rozalina Sensusiati, Anggraini Dwi Subagio, Eko Agus Tedy Apriawan Tsabita Hadid Valeryna, Natasha Vatine Adila Vita Kusuma Rahmawati Wibowo, Caesaroy Afif

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