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Terapi Radiasi Eksternal dengan Metode Hypofractionated pada Kanker payudara Post Breast Conserving Surgery di Instalasi Onkologi Radiasi Rumah Sakit Indriati Solo Baru: Studi Kasus Rorong, Fabrizio Alessandro; Prasetya, I Made Lana; Juliasa, I Wayan
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.v1i1.11878

Background: Radiotherapy is one method of cancer treatment that uses radiation to destroy cancer cells. Radiation dose delivery is done gradually through a process called fractionation, which is divided into conventional and hypofractionated fractions. In the radiation oncology installation of the new Indriati Solo Hospital, some breast cancer patients have received treatment with the hypofractionated method, while the majority still use the conventional fraction method. The hypofractionated method aims to reduce the number of treatment sessions by increasing the dose in each fraction with outcomes comparable to conventional fractions.Methods: This research method is descriptive qualitative with a case study approach. The study involves breast cancer patients post-Breast Conserving Surgery (BCS), Data were gathered through interviews with radiation oncologists, radiotherapists, and medical physicists, along with direct observations and patient record analysis The collected data were analyzed descriptively to evaluate the application and effectiveness of the hypofractionated method.Results: The results showed that the use of hypofractionated can shorten OTT (Overall Treatment Time), as well as better side effects than conventional fractions, and effectively reduce the number of queues of radiotherapy patients. In conclusion, the use of the hypofractionated method is very effective and recommended for radiotherapy treatment in breast cancer.Conclusions: Hypofractionated radiotherapy for breast cancer patients at Indriati Solo Baru has proven effective in reducing OTT and patient queues, with outcomes comparable to conventional fractionation. Further research is needed to assess long-term benefits, including quality of life, recurrence rates, cost-effectiveness, and dose distribution, particularly in high-volume healthcare settings. Hypofractionated radiotherapy is a promising alternative.

Terapi Radiasi Eksternal dengan Metode Hypofractionated pada Kanker payudara Post Breast Conserving Surgery di Instalasi Onkologi Radiasi Rumah Sakit Indriati Solo Baru: Studi Kasus Rorong, Fabrizio Alessandro; Prasetya, I Made Lana; Juliasa, I Wayan
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.v1i1.11878

Background: Radiotherapy is one method of cancer treatment that uses radiation to destroy cancer cells. Radiation dose delivery is done gradually through a process called fractionation, which is divided into conventional and hypofractionated fractions. In the radiation oncology installation of the new Indriati Solo Hospital, some breast cancer patients have received treatment with the hypofractionated method, while the majority still use the conventional fraction method. The hypofractionated method aims to reduce the number of treatment sessions by increasing the dose in each fraction with outcomes comparable to conventional fractions.Methods: This research method is descriptive qualitative with a case study approach. The study involves breast cancer patients post-Breast Conserving Surgery (BCS), Data were gathered through interviews with radiation oncologists, radiotherapists, and medical physicists, along with direct observations and patient record analysis The collected data were analyzed descriptively to evaluate the application and effectiveness of the hypofractionated method.Results: The results showed that the use of hypofractionated can shorten OTT (Overall Treatment Time), as well as better side effects than conventional fractions, and effectively reduce the number of queues of radiotherapy patients. In conclusion, the use of the hypofractionated method is very effective and recommended for radiotherapy treatment in breast cancer.Conclusions: Hypofractionated radiotherapy for breast cancer patients at Indriati Solo Baru has proven effective in reducing OTT and patient queues, with outcomes comparable to conventional fractionation. Further research is needed to assess long-term benefits, including quality of life, recurrence rates, cost-effectiveness, and dose distribution, particularly in high-volume healthcare settings. Hypofractionated radiotherapy is a promising alternative.

Prosedur Pemeriksaan MSCT Pelvis Studi Kasus Tumor Pelvis di Instalasi Radiologi RSUD Muhammad Sani Karimun Wedayanti, Luh Deva; Juliasa, I Wayan; Suci, Puspa Pamella
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.v12i1.14199

Background: Multislice Computed Tomography (MSCT) is widely used for pelvic imaging because of its high spatial resolution, rapid acquisition time, and multiplanar reconstruction capability. Pelvic tumors require detailed evaluation of their margins, extent, and anatomical relationships with surrounding structures. At Muhammad Sani Hospital Karimun, MSCT pelvis examinations for suspected pelvic tumors are performed using a two-stage protocol: an initial intravenous (IV) contrast-enhanced scan followed by a second scan utilizing intragenital iodine contrast and rectal air as negative contrast. This imaging approach differs from standard MSCT pelvis protocols and is applied to improve visualization of tumor boundaries in selected cases. Methods: This study is a descriptive observational study in the form of a case report involving a single patient who underwent a two-stage MSCT pelvis examination. Result: The first stage, using IV contrast enhancement, provided information regarding tumor location, density characteristics, and possible extension but was limited in clearly defining tumor margins. The second stage involved intragenital administration of iodine contrast through catheterization and rectal air insufflation, which improved visualization of the anatomical boundaries between the tumor, urinary bladder, and rectosigmoid colon. Imaging findings were assessed descriptively without inferential statistical comparison between techniques. A cystic-solid mass measuring 10.5 × 6.2 × 8.4 cm was identified in the right pelvic region, along with an isodense mass measuring 4.0 × 6.2 cm in the left pelvis. The combined imaging approach subjectively enhanced visualization of tumor margins and anatomical relationships compared to the initial IV contrast scan alone, thereby increasing diagnostic confidence in tumor characterization. Conclusions: The two-stage MSCT pelvis protocol using IV contrast followed by intragenital iodine contrast and rectal air may provide improved visual delineation of pelvic tumor margins in this observed case. This technique represents a practical clinical variation of the anal marker method. However, the observed improvement is descriptive in nature and not based on comparative inferential analysis. Further studies with larger sample sizes and standardized comparison are required before drawing definitive conclusions or recommending routine implementation of this protocol.

Analisis Teknik Radiotherapy Non-Coplanar (NC) 3 Dimension Conformal Radiation Therapy (3D-CRT) Pada Kasus Acute Lymphoblastic Leukemia (ALL) Di RSUP DR. Hasan Sadikin Bandung Rondonuwu, Roucho Yusuf; Sukmasari, Indah; Juliasa, I Wayan; Alfiah, Farikhatul
Jurnal Ilmu Kedokteran dan Kesehatan Vol 13, No 4 (2026): Volume 13 Nomor 4
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v13i4.22851

Craniospinal irradiation (CSI) merupakan teknik radioterapi yang digunakan untuk menangani keganasan yang melibatkan otak dan sumsum tulang belakang, seperti acute lymphoblastic leukemia (ALL). Tantangan utama dalam pelaksanaan CSI adalah mencapai distribusi dosis yang homogen pada target kranial dan spinal, serta meminimalkan paparan dosis terhadap organ at risk (OAR). Penelitian ini merupakan studi seri kasus pada empat pasien pediatrik dengan ALL yang menjalani terapi CSI di RSUP Dr. Hasan Sadikin Bandung. Perencanaan terapi dilakukan menggunakan simulasi berbasis CT dengan perangkat imobilisasi yang dirancang khusus untuk pasien pediatrik. Teknik 3D-CRT non-coplanar pada CSI dengan penggunaan lima lapangan penyinaran, penyesuaian sudut gantry, rotasi meja (couch), verifikasi harian menggunakan image-guided radiotherapy (IGRT), serta imobilisasi khusus pediatrik, mampu memberikan cakupan target yang optimal dengan dosis OAR tetap dalam batas aman. Hasil perbandingan menunjukkan bahwa nilai Dmax dan Dmean pada organ kritis seperti lensa, mata, saraf optik, tiroid, paru-paru, jantung, ginjal, dan hati sesuai dengan standar rumah sakit dan data referensi, dengan variasi antar pasien yang minimal. Pendekatan ini efektif dalam meminimalkan paparan terhadap jaringan sehat sekaligus mempertahankan presisi penyinaran, sehingga layak digunakan dalam tatalaksana CSI pada kasus ALL. Kesimpulannya, teknik 3D-CRT non-coplanar mampu menghasilkan distribusi dosis yang merata pada area CSI dengan risiko overlap yang minimal. Perencanaan berbasis CT 3D dan delineasi yang presisi mampu menjaga dosis OAR tetap dalam batas aman. Sistem imobilisasi khusus pediatrik juga meningkatkan stabilitas dan reprodusibilitas, sehingga metode ini aman, efektif, dan layak diterapkan pada pasien pediatrik yang menjalani CSI.

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