Hasil Pencarian  ::  Simpan CSV :: Kembali

"Dosis pada LGK Perfexion dihitung untuk setiap tembakan dengan jumlahkan kontribusi dari 192 sumber radiasi yang dipancarkan dari cobalt-60. Secara umum, bentuk tengkorak pasien dimodelkan berdasarkan 24 skull measurement. Namun, karena keterbatasan pengukuran menggunakan 24 ukuran tengkorak, kontur yang dihasilkan perbedaan dari kepala pasien yang sebenarnya berdasarkan citra MRI. Penelitian ini dilakukan untuk distribusi dosis LGK Perfexion menggunakan kontur yang dihasilkan oleh pengukuran manual dan citra CT. Film GAFChromic EBT3 diletakan pada fantom anthropomorphik. Pemindai Epson 10000 XL dan ImageJ digunakan untuk menghasilkan hasil dari pengukuran. Hasil kalkulasi dosis titik menggunakan kontur dari citra CT menunjukan nilai yang lebih baik untuk semua kolimator dan bentuk target yang sama dengan nilai rata deviasi 1,3 ± 0,87, sedangkan jika menggunakan 24 ukuran tengkorak menunjukan nilai rata rata deviasi 4,03 ± 3,73.

---

The dose on LGK Perfexion is calculated for each shot by adding up the contributions of the 192 radiation sources emitted from the cobalt-60. In general, the patient's skull shape is modeled based on 24 skull sizes. However, due to the limitations of measurements using 24 skull sizes, the contours of the resulting differences from the actual patient's head based on the MRI images. This study was conducted for the dose distribution of LGK Perfexion using contours generated by manual measurements and CT images. The GAFChromic EBT3 film is set on an anthropomorphic ghost. An Epson 10000 XL and an ImageJ scanner were used to generate the measurement results. The result of point dose calculation using CT image contour shows a higher value good for all collimators and the same target shape with a mean deviation value of 1.3 ± 0.87, whereas if using 24 skull sizes it shows a mean deviation value of 4.03 ± 3.73."

"Latar BelakangPeningkatan insiden setiap tahun menjadikan meningioma sebagai salah satu masalah primer tumor jinak sistem saraf pusat (54,5%), dengan karakteristik laju pertumbuhan dan rekurensi tinggi. Maka, diperlukan penetapan rangkaian tatalaksana meningioma yang efektif dan efisien, dengan mempertimbangkan faktor pasien, lokasi tumor, volume, dan riwayat medis.MetodePenelitian menggunakan pendekatan studi potong lintang deskriptif-analitik untuk mengamati luaran radiologis meningioma pasca-GKRS. Digunakan data rekam medis pasien meningioma dari tahun 2018 hingga 2023 berupa MRI follow up satu tahun pasca- GKRS. Selain penyajian data pasien meningioma pasca-GKRS secara deskriptif, dilakukan analisis data laju pertumbuhan meningioma pasca-GKRS terhadap volume awal, lokasi, dan riwayat tindakan pra-GKRS.HasilDari 50 data rekam medis, sebanyak 44% tumor alami regresi; 44% tumor ukuran stabil, dan 12% tumor mengalami peningkatan ukuran. Mayoritas pasien meningioma pasca- GKRS berjenis kelamin perempuan, berusia 46 – 59 tahun, memiliki lokasi tumor supratentorial, volume awal ≤30 cc, dan tanpa riwayat tindakan pra-GKRS. Tidak ditemukan adanya hubungan bermakna antara laju pertumbuhan meningioma pasca- GKRS terhadap volume awal, lokasi, maupun riwayat tindakan pra-GKRS. KesimpulanLaju kontrol pertumbuhan tumor meningioma mencapai efektivitas 88% dalam jangka satu tahun pasca-GKRS. Tidak didapatkan hubungan bermakna antara volume awal, lokasi meningioma, maupun riwayat tindakan pra-GKRS terhadap luaran laju pertumbuhan tumor tertentu.

---

Introduction

Increasing incidence of meningioma every year makes it one of the primary problems of benign tumors of the central nervous system (54.5%), with characteristics of high growth rate and recurrence. Therefore, it is necessary to determine an effective and efficient management of meningioma by considering patient factors, tumor location, volume, and medical history. One of the newest meningioma treatment modalities in Indonesia is Gamma Knife Radiosurgery, a minimally invasive radiation surgery. Although it has been implemented since 2018, there are no studies analyzing the outcomes of Gamma Knife treatment for meningioma patients at RSUPN Dr. Cipto Mangunkusumo.

Method

The study used a descriptive-analytic cross sectional study approach to observe the radiological outcomes of meningioma after Gamma Knife. Medical record data of meningioma patients from 2018 to 2023 in the form of MRI follow-up one year after GKRS was used. In addition to descriptive presentation of Gamma Knife meningioma patient data (age and gender), significance tests of meningioma control rate after Gamma Knife have been analyzed towards the initial volume, location, and medical history prior to GKRS.

Results

Of the 50 medical records, 44% had regression, 44% had stable size, and 12% had increased size. The majority of GKRS meningioma patients were female, aged 46 - 59 years, had supratentorial tumor location, initial volume ≤30 cc, and no history of pre- GKRS treatment. There was no significant relationship between meningioma control rate after GKRS and initial volume, location, or history of pre-GKRS treatment.

Conclusion

The meningioma tumor growth control rate reached 88% effectiveness within one year after Gamma Knife. There was no significant association between initial volume, meningioma location, or history of pre-GKRS treatment on the trend of specific tumor control rate outcomes."

"Leksell gamma knife (LGK) adalah salah satu modalitas terapi radiasi yang bersumber dari radioaktif Co-60. Teknik lapangan kecil dengan pemberian dosis radiasi tinggi kepada pasien dalam satu sesi harus dihitung secara akurat dan diverifikasi dengan cermat. Penelitian ini menggambarkan prosedur untuk memverifikasi keakuratan distribusi dosis pada Leksell Gamma Plan (LGP) menggunakan fantom RANDO dan film gafchromic EBT3. Pertama, dilakukan verifikasi berkas profil pada fantom standar LGK dan RANDO menggunakan ukuran kolimator 4 mm, 8 mm dan 16 mm untuk memperoleh nilai full width half maximum (FWHM), penumbra dan beam-symmetry, nilai FWHM yang diperoleh dibandingkan dengan nilai pada LGP. Selanjutnya verifikasi nilai dosis serap pada RANDO dengan vasiasi ukuran kolimator, jumlah shoot, volume dan lokasi tumor, diverifikasi mengggunakan film EBT3. Perhitungan distribusi dosis dilakukan menggunakan perangkat lunak ImageJ dan program MATLAB. Penelitian ini menunjukkan perbedaan nilai FWHM dan beam-symmetry terkecil antara LGP ​​dan fantom standar LGK terjadi pada ukuran kolimator 16 mm sebesar 0.42 mm dan 1.58% sedangkan perbedaan pada fantom RANDO adalah 0.45 mm dan 1.64%. Verifikasi dosis maksimum menunjukkan pada variasi jumlah shoot, kolimator 16 mm memiliki nilai deviasi yang paling stabil. Kesimpulannya, kolimator ukuran 16 mm memiliki akurasi nilai dosis, FWHM dan beam-symmetry sangat baik. Namun, pada volume tumor yang lebih kecil, kolimator 16 mm dengan single shoot memberikan nilai deviasi yang lebih tinggi.

---

Leksell gamma knife (LGK) is an advanced modality of radiation therapy sourced Co-60 radioactive for treating patient with intracranial lesion. Small field techniques with highly integrated radiation delivering to patients in single session must be calculated accurately and verified carefully. This study illustrates a procedure to verify the accuracy of dose distribution associated with Leksell Gamma Plan (LGP) using RANDO phantom and gafchromic EBT3 film dosimetry. First, we assessed the profile dose on LGK standard phantom with collimators size 4,8 and 16 mm and compared the results with the profile dose based on RANDO to obtained Full Width Half Maximum (FWHM), penumbra and beam-symmetry. Absorbed-dose distributions on RANDO with various combinations of lesion volume, collimator size, location and number of shots assessed by EBT3 film using LGK Perfexion. Scanned images of the measured films were processed following standard EBT3 film-handling procedures. Dose value calculation were performed using ImageJ software and MATLAB in-house software. The study shows samallest difference of FWHM and beam symmetry occurs at collimator size 16 mm, whereas discrepancy in standard phantom between LGP and measurement is 1.83 % and 1.58 % respectively and the discrepancy in RANDO phantom is 2.15 %, and 1.64 % respectively. Verification of max dose shows, colimator size 16 mm has the most stable deviation value in variation of number of shoots. In conclusion, collimator size 16 mm have a highest accuracy of dose value, FWHM and beam-symmetry value. However, on smaller lesion volume, collimator 16 mm with single shot give higher deviation dose value."