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Uji Diagnostik Pemeriksaan Osteosklerotik Tulang dengan Sistem Radiografi Digital Susilo, Susilo; Nagoro, Maesadji Tjokro; Kusminarto, Kusminarto; Budi, Wahyu Setia
MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 3 Year 2011
Publisher : MEDIA MEDIKA INDONESIANA

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ABSTRACTDiagnostic test of bone osteosclerotics examination using digital radiography systemBackground: The interpretation of a conventional röntgen images have a high degree of subjectivity due to the limitation of humansight. The computationally detection help establish the accuracy of diagnosis of the radiologist. According to our knowledge, there has not been previous research on this issue in Indonesia. The research was aimed to examine a Matlab based software to determine the diagnostic value in the diagnosis of osteosclerotic bone.Methods: This study was a diagnostic test which was conducted in Radiology Department of Dr. Kariadi Hospital Semarang, Dr.Sardjito Hospital Yogyakarta and Bethesda Hospital Yogyakarta, April to August 2009. The radiographs of bone osteosclerotic resulted from computed radiography (CR) test results were taken consecutively, interpreted by a radiologist which was supported by the Anatomical Pathology Laboratory examination as a gold standard. Afterwards these steps were done respectively: classify patients as a normal or osteosclerotic patients based on the cut off point that was determined, calculate the value of the diagnostic by analysis of 2x2 tables, determine the area under the curve (AUC) by the procedure of receiver operating characteristic (ROC), anddetermine the optimal of COP (cut off point) using ROC procedure.Results: From the results of diagnostic tests of bone radiographs these following parameter values was obtained: AUC value of 97.6% (95% CI: 94.4%-100%), the optimal cut off point for bone oseosclerotic COP ≥1.05 with a sensitivity value of 93.0% and a specificity of 89.1%. Suitability kappa value of 0.818 K (95% CI: 0.757 to 0.879).Conclusion: The radiographic examination of the results of CR using Matlab-based software can be used to diagnose boneosteosclerotic with high sensitivity and specificity.Keywords: Bone osteosclerotic, röntgen images, optimal of COP, Matlab softwareABSTRAKLatar belakang: Pembacaan foto röntgen secara konvensional memiliki tingkat subyektivitas tinggi karena keterbatasan indrapenglihatan manusia. Pendeteksian secara terkomputasi membantu menegakkan diagnosis para radiolog. Sebagaimana diketahui, belum ada penelitian sebelumnya mengenai masalah ini di Indonesia. Penelitian ini bertujuan menguji perangkat lunak berbasis Matlab untuk menentukan nilai diagnostik pada diagnosis tulang osteosklerotik.Metode: Penelitian ini adalah uji diagnostik yang dilakukan di Bagian Radiologi RSUP Dr. Kariadi Semarang, RSUP Dr. SardjitoYogyakarta dan Rumah Sakit Bethesda Yogyakarta, April-Agustus 2009. Radiograf osteosklerotik tulang hasil pemeriksaan CR (computed radiography) diambil untuk sampel secara konsekutif, kemudian diperiksa oleh radiolog yang didukung oleh pemeriksaan Laboratorium Patologi Anatomi sebagai baku emas. Tahapan yang dilakukan berturut-turut adalah: mengelompokkan pasien sebagai osteosklerotik dan normal berdasar titik potong yang ditentukan, menghitung nilai diagnostik dengan tabel analisis 2x2, menentukan AUC (area under the curve) dengan prosedur ROC (receiver operating characteristic), dan menentukan COP (cut off point) optimal dengan prosedur ROC.Hasil: Hasil uji diagnostik radiograf tulang diperoleh nilai-nilai parameter sebagai berikut: nilai AUC adalah sebesar 97,6% (IK 95%: 94,4%-100%), titik potong optimal untuk osteosklerotik tulang COP ≥1,05 dengan nilai sensitivitas sebesar 93,0% dan spesifisitas sebesar 89,1%. Nilai kesesuaian kappa K sebesar 0,818 (IK 95%: 0,757-0,879).Simpulan: Pemeriksaan radiografi hasil CR menggunakanperangkat lunak berbasis Matlab dapat digunakan untukmendiagnosis osteosklerotik tulang dengan sensitivitas danspesifisitas tinggi
Uji Diagnostik Pemeriksaan Tulang Osteolitik Berbasis Intensitas Citra Digital Susilo, Susilo; Nagoro, Maesadji Tjokro; Kusminarto, Kusminarto; Budi, Wahyu Setia
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 1 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

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Diagnostic test of osteolytic bone examination based on digital image intensityBackground: The visual examination of bone radiographs using digital computed radiography (CR) is an examination for the diagnosis of bone-metastatic cancer. The subjectivity of interpretation of bone radiographs may lead to doctor’s doubt in making decision to treatment patients with bone-metastatic cancer. Software Matlab-based computer application program makes a standard method to organize the results of bone radiographs. The objective of this study is to develop a software based on Matlab to analyze the diagnostic values, and to determine the optimal of cut off point to diagnose of osteolytic bone.Method: The researches data are collected from Department of Radiology of three hospitals i.e. Dr. Kariadi Hospital Semarang, Dr. Sardjito Hospital and Bethesda Hospital Yogyakarta. This research was carried out during four month from April to August 2009. Radiographs of osteolytic bone interpreted by radiologist were compared with PA examination result of the osteolytic bone which were viewed as the gold standard. The steps in this study i.e. patients are classified as a normal or osteolytic bone patients based on the cut off point that had been determined, calculate the value of the diagnostic test using 2x2 tables, determined the area under the curve (AUC) by the procedure of receiver operating characteristic (ROC), and determined the optimal of cut off point.Result: The results of study show that the diagnostic test for osteolytic bone by using Matlab-based software has sensitivity of 0.88, specificity of 0.891, positive expected value of 0.897, negative expected value of 0.950 and the cut off point at 0.93, while, the value of area under the curve (AUC) is 94% (95% CI: 89.7%-98.3%), and the accuracy is 0.881 for the case of osteolytic bone.Conclusion: Matlab-based software being used for diagnosing osteolytic bone has relatively high sensitivity and specificity.Keywords: Digital image, bone metastases, osteolytic, optimum cut off point ABSTRAKLatar belakang: Pemeriksaan radiograf tulang secara visual menggunakan sistem radiografi digital CR (computed radiography) merupakan pemeriksaan untuk diagnosis kanker metastasis tulang. Subyektivitas interpretasi radiograf tulang dapat menyebabkan keraguan dokter dalam mengambil keputusan untuk pengobatan pasien dengan kanker tulang metastatik. Software berbasis program aplikasi computer Matlab membuat suatu metode standard untuk mengorganisasikan hasil radiograf tulang. Tujuan penelitianadalah mengembangkan software berbasis Matlab untuk menganalisis nilai-nilai diagnostik, cut off point optimal dan akurasi pemeriksaan pada diagnosis tulang osteolitik.Metode: Data penelitian diambil di bagian radiologi dari tiga rumah sakit, yaitu RSUP Dr. Kariadi Semarang, RSUP Dr. Sardjito dan Rumah Sakit Bethesda Yogyakarta. Penelitian dilakukan selama empat bulan dari April sampai Agustus 2009. Radiograf tulang  osteolitik yang diinterpretasikan oleh radiolog ini dibandingkan dengan hasil pemeriksaan PA tulang osteolitik yang dianggap sebagai gold standard. Langkah yang dilakukan dalam penelitian ini adalah pasien diklasifikasikan sebagai pasien tulang normal dan pasien osteolitik berdasar cut off point yang telah ditetapkan, menghitung nilai uji diagnostik menggunakan tabel 2x2, menghitung luasan di bawah kurva (AUC) dengan cara receiver operating characteristic (ROC), serta menetapkan cut off point optimal.Hasil: Hasil penelitian menunjukkan bahwa uji diagnostik tulang osteolitik menggunakan software berbasis Matlab memiliki sensitivitas 0,875, spesifisitas 0,891, nilai dugapositif 0,897, nilai duga negatif 0,950 dan cut off point 0,93. Nilai luasan di bawah kurva (AUC) ROC adalah sebesar 94%
KAJIAN RADIOGRAFI DIGITAL TULANG TANGAN Susilo, Susilo; Setiabudi, Wahyu; Kusminarto, Kusminarto; Suparta, G. B.
BERKALA FISIKA Vol 16, No 1 (2013): Berkala Fisika
Publisher : BERKALA FISIKA

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Teknologi diagnostik medis yang digunakan pada unit radiologi di rumah sakit sudahcenderung bergeser dari teknologi analog berbasis film menjadi teknologi digital (filmless). Salahsatu cara membuat system radiografi tanpa film adalah dengan cara konversi digital menggunakantabung kedap cahaya (light tight tube). Dalam penelitian ini, kami telah mengkaji kemungkinanpemanfaatan sistem pencitraan radiografi digital sinar-x berbasis X-Ray Intensifying Screen(XRIS) dihubungkan dengan perangkat frame-grabber. Hasil eksperimen tahap awal untukmemperoleh radiograf tulang tangan menunjukkan bahwa sistem ini cukup dioperasikan padategangan anode-katode 50 kV, arus waktu filamen 50 mAs dan waktu paparan 0,1 detik untukmenghasilkan citra yang cukup dapat dilihat. Untuk sekali paparan, dimungkinkan memperolehbeberapa citra untuk obyek yang sama pada posisi tetap, tipa-tiap citra mengandung informasiradiografi berbeda ditunjukkan oleh distribusi tiap citra yang bervariasi. Hasil ini menunjukkanbahwa sistem ini diharapkan lebih efisien dan lebih efektif dibandingkan dengan metodekonvensional berbasis film, dan dapat dikembangkan untuk diagnose mineral tulang.Kata kunci: radiografi digital; filmless; sinar-x; tulang tangan
ANALISIS HOMOGENITAS BAHAN ACRYLIC DENGAN TEKNIK RADIOGRAFI SINAR-X Susilo, Susilo; Budi, W.S.; Kusminarto, Kusminarto
Jurnal Fisika Vol 1, No 1 (2011)
Publisher : Jurnal Fisika

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Telah dilakukan pengukuran terhadap stepwedge buatan sendiri dari bahan acrilyc yang ada dipasaran untuk uji homogenitas bahan dengan menggunakan sistem Radiografi Digital (RD) dan sistem CR (Computed Radiography). Data hasil pemotretan yang berupa file citra stepwedge kemudian dianalisis dengan perangkat lunak berbasis program aplikasi Matlab 7.1. Hasil perhitungan indeks-keabuan yang dapat digrafikkan untuk menunjukkan bahwa hubungan antara indeks-keabuan dan ketebalan step dari stepwedge menggunakan sistem RD bersifat linear dan dapat dinyatakan secara matematis sebagai Y = 0,1292X +0,0432 dengan R2 =0,9988. Persamaan ini juga sesuai dengan indeks-keabuan stepwedge menggunakan CR dan diperoleh persamaan linear: 0,0955X  + 0,4275 dengan R2 = 0,9996. Hasil ini menunjukkan bahwa sistem ini diharapkan dapat dikembangkan dalam pengadaan stepwedge buatan sendiri untuk uji homogenitas pesawat radiografi diagnostik sehingga lebih efektif dan efisien.   Kata-kata kunci: stepwedge, Radiografi Digital, Computed Radiography, tingkat keabuan
IMPLIKASI KKNI PADA KURIKULUM DAN PEMBELAJARAN SAINS Kusminarto, Kusminarto
PROSIDING : Seminar Nasional Fisika dan Pendidikan Fisika Vol 5, No 1 (2014)
Publisher : PROSIDING : Seminar Nasional Fisika dan Pendidikan Fisika

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Pemerintah telah mempersiapkan peraturan perundangan yang mengatur masalah ketenagakerjaan untuk mendapatkan pengakuan kesetaraan oleh masarakat global. Institusi perguruan tinggi adalah lembaga yang bertanggung jawab menyiapkan tenaga kerja melalui pendidikan formal dalam jenjang vokasi, sarjana, pascasarjana serta profesi. Oleh karena itu perguruan tinggi juga harus menyesuaikan diri dengan keadaan tersebut di atas di antaranya melalui penyesuaian kurikulum dan proses pembelajarannya agar lulusan yang dihasilkan mendapat pengakuan kesetraan tersebut. Melalui Kerangka Kualifikasi Nasional Indonesia (KKNI) lembaga pendidikan formal khususnya perguruan tinggi harus menyesuaikan diri. Kata kunci: Kurikulum, KKNI, capaian pembelajaran.
Penyempitan Lebar Garis Spektral Keluaran Laser Zatwarna Pulsa Dengan Pasangan-Pasangan Prisma Maruto, Guntur; Kusminarto, Kusminarto; Hermanto, Arief; Nurwantoro, Pekik
Berkala Ilmiah MIPA Vol 23, No 1 (2013)
Publisher : FMIPA UGM

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Penelitian untuk penyempitan garis spektral luaran berkas laser zatwarna dipaparkan dalam paper ini. Untuk mengamati secara langsung garis spektralnya, berkas laser didispersikan oleh kisi pantul di dalam wavelength-meter dan dilihat dari mikroskop pada wavelength-meter. Lebar garis spektral dapat diketahui dengan pertolongan garis-garis skala di dalam wavelength-meter. Spektrum berkas laser yang terlihat dari mikroskop dipotret untuk dapat dan mudah diperlihatkan dalam bentuk foto. Upaya untuk mempersempit lebar garis spektral luaran berkas laser dilakukan dengan menempatkan pasangan prisma-prisma di dalam resonator optik unit laser. Dengan menempatkan 2 pasang prisma telah diperoleh penyempitan garis spektral dengan faktor sekitar 1/30. Hasil penyempitan garis spektral luaran berkas laser telah diuji dengan menggunakan berkas laser tersebut dalam Sistem Spektroskopi Laser-Berkas Atom untuk mengamati garis-garis D1 dan D2 pada atom natrium (Na). Dari uji spektroskopi ini efek penyempitan garis spektral berkas laser terlihat dengan jelas
Clinical trial design of Boron Neutron Capture Therapy on breast cancer using D-D coaxial compact neutron generator as neutron source and Monte Carlo N-Particle simulation method Pasaribu, Rosenti; Kusminarto, Kusminarto; Sardjono, Yohannes
Indonesian Journal of Physics and Nuclear Applications Vol 1 No 1 (2016)
Publisher : Fakultas Sains dan Matematika Universitas Kristen Satya Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (578.821 KB) | DOI: 10.24246/ijpna.v1i1.34-43

Abstract

A clinical trial simulation of Boron Neutron Capture Therapy (BNCT) for breast cancer was conducted at National Nuclear Energy Agency Yogyakarta, Indonesia. This was motivated by high rate of breast cancer in the world, especially in Indonesia. BNCT is a type of therapy by nuclear reaction 10B(n,α)7Li that produces kinetic energy totaling 2.79 MeV. High Linear Energy Transfer (LET) radiation of α-particle and recoil 7Li would locally deposit their energy in a range of 5-9 μm, which corresponds to the human cell diameter. Fast neutron coming out of Compact Neutron Generator (CNG) was moderated using Fe and MgF2 material. A collimator, along with breast cancer and the corresponding organ at risk were designed compatible to Monte Carlo N-Particle X (MCNPX). The radiation were simulated by the MCNPX software and the physical quantities were counted by tally MCNPX codes. The highest neutron thermal flux was found at a depth of 1.4 cm on fat tissue. En face and upward intersection radiation techniques were adopted for the breast cancer radiation. The average dose rate of radiation used on breast cancer was 1.72×10-5 Gy/s for the en face method and 8.98×10-6 Gy/s for the upward intersection method. Dose 50±3 Gy was given into cancer cell, (4.18±0.06) ×10-2 Gy into heart and (8.16±0.06) ×10-2Gy into lung for 806.34 hours irradiation.
Boron Neutron Capture Therapy (BNCT) using Compact Neutron generator Susilowati, Anggraeni Dwi; Kusminarto, Kusminarto; Sardjono, Yohannes
Indonesian Journal of Physics and Nuclear Applications Vol 1 No 2 (2016)
Publisher : Fakultas Sains dan Matematika Universitas Kristen Satya Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (879.192 KB) | DOI: 10.24246/ijpna.v1i2.73-80

Abstract

Boron Neutron Capture Therapy (BNCT) must be appropriate with five criteria from IAEA. These criteria in order to prevent neutron beam output harm the patient. It can be by using Collimator of neutron source Compact Neutron Generator (CNG) and Monte Carlo simulation method with N particles 5 .CNG is developed by deuteriumtritium reaction (DT) and deuterium-deuterium (DD) reaction. The manufacture result of the collimator is obtained epithermal neutron flux value of 1.69e-9 n/cm^2s  for D-T reaction and 8e6 n/cm^2s for D-D reaction, ratio of epithermal and thermal is 1.95e-13 Gy cm^2/n for D-T reaction and for D-D reaction, ratio of fast neutron component is 1.69e-13 Gy cm^2/n for D-T reaction and for D-D reaction, ratio of gamma component is 1.18e-13 Gy cm^2/nfor D-T reaction and for D-D reaction. The Latest reaction is current ratio 0.649 for D-T reaction and 0.46 for D-D reaction.
Preparation of Dosimetry of Boron Neutron Capture Therapy (BNCT) for In vivo Test Planning system using Monte Carlo N-Particle Extended (MCNP-X) Software Arrozaqi, Muhammad Ilma Muslih; Kusminarto, Kusminarto; Sardjono, Yohannes
Indonesian Journal of Physics and Nuclear Applications Vol 1 No 2 (2016)
Publisher : Fakultas Sains dan Matematika Universitas Kristen Satya Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (676.344 KB) | DOI: 10.24246/ijpna.v1i2.99-107

Abstract

Cancer is a disease with second largest patients in the world.  In Indonesia, the number of radiotherapy facility in Indonesia is less than 30 units and every patients needs more than single exposure, so that it result a long waiting list of treatment up to one year. Now, a new treatment of cancer is developed. It is Boron Neutron Capture Therapy that using capture reaction of neutron by Boron-10. Before this method is applied to patient, it requires some testing which is one of them is in vivo test. This research has been conducting to prepare the in vivo test, especially in dosimetry. Preparation of dosimetry includes collimator design and mouse phantom model. The optimum specification of the collimator is consist of Nickel collimator wall with 2 cm of thickness, Aluminum moderator with 10 cm of thickness and lead gamma shield with 3.5 of thickness. This design result in 1.18 x 108 n/cm2s of epithermal and thermal neutron flux, 2,24 x 10-11 Gy cm2/s of fast neutron component dose, 1.35 x 10-12 Gy cm2/s of gamma dose component, and 7.18 x 10-1 of neutron current and flux ratio. Mouse phantom model is built by two basic kind of geometry, they are Ellipsoid and Elliptical Tory. Both of basic geometry can be used to make all important organs of mouse phantom for dosimetry purpose.
Optimization of a Beam Shaping Assembly Design for Boron Neutron Capture Cancer Therapy Facility Based on 30 MeV Cyclotron Ardana, I Made; Kusminarto, Kusminarto; Sardjono, Yohannes
Indonesian Journal of Physics and Nuclear Applications Vol 1 No 3 (2016)
Publisher : Fakultas Sains dan Matematika Universitas Kristen Satya Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1528.697 KB) | DOI: 10.24246/ijpna.v1i3.128-137

Abstract

A series of simulations has been carried out using a Monte Carlo N Particle X code to find out the final composition and configuration of a neutron Beam Shaping Assembly (BSA)  to moderate the fast neutron flux which is generated from the thick disk-type beryllium target. The final configuration for neutron BSA design included 35 cm lead as reflector, 39 cm alumina as moderator, 8.2 cm lithium fluoride as fast neutron filter and 0.5 cm boron carbide as thermal neutron filter. Bismuth, lead fluoride, and lead were chosen as the aperture, reflector, and gamma shielding, respectively. The disk-type of beryllium target is 19 cm in diameter with 0.5 cm thickness which is covered by copper plate to hold the water pressured coolant. A higher yield of neutron production requires a higher intensity of proton beams, which generate much heats and causes the target material to melt. Therefore, it is useful to consider the temperature distribution on the target material with flowing water coolant by means of computer modeling while designing the target. ANSYS-Fluent code will be used to estimate the thermal transfer and heat calculation in a solid target during beam irradiation. Epithermal neutron flux in the suggested design were 1,03x109 n/cm2 s, with almost all IAEA parameters for BNCT BSA design has been satisfied.