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"Studi dilakukan pada 20 pasien intervensi jantung: 12 coronary angiography (CA) dan 8 percutaneous transluminal coronary angioplasty (PTCA). Dosis permukaan diukur menggunakan DAP (dose-area product) dan gafChromic XR-RV3 yang ditempelkan pada permukaan kulit. Distribusi dosis permukaan dapat digambarkan pada film gafChromic. Selain itu, diukur pula dosis hambur pada tiroid, gonad dan mata. Citra dianalisis menggunakan algoritma In-house pada channel merah RGB standar. Korelasi antara dosis maksimum permukaan (MESD) dan DAP untuk kedua prosedur diinvestigasi. Ditemukan korelasi cukup signifikan (R2 = 0.86) antara DAP and MESD (R2 = 0.96 for CA and R2 = 0.82 for PTCA) sehingga pengukuran DAP tidak bisa dijadikan satu-satunya indicator untuk merepresentasikan dosis kulit pasien.Hasil pengukuran film gafChromic menunjukkan bahwa dosis radiasi kulit pada prosedur PTCA lebih besar dibanding CA.Korelasi yang rendah antara MESD dan waktu fluoroskopi total (R2 = 0.44 dengan R2 = 0.26 untuk CA dan R2 = 0.29 untuk PTCA). Untuk dosis hamburan balik pada organ kritis, tiroid mendapat dosis tertinggi (1.45 cGy) diikuti oleh gonad (1.05 cGy) dan mata (0.61 cGy).

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Twenty patients cardiac intervention procedures were studied : 12 coronary angiography (CA) dan 8 percutaneous transluminal coronary angioplasty (PTCA). The entrance skin dose were measure using DAP (dose-area product) and gafChromic XR-RV3 radiochromic film attached to the skin. gafChromic film measurement will be obtain the skin dose distribution on the back area of the coronary area. In addition, we also measure scattered dose on the tiroid, gonad and eyes. Image analysis was performed using red channel component of standart RGB (red, green and blue) color space image. The correlation between maximum entrance surface dose and dose area product for two interventional procedures was investigated. We found a significant correlation R2 = 0.86 of DAP (dose-area product) and MESD (R2 = 0.96 for CA and R2 = 0.82 for PTCA) so that DAP measurement cannot only be the one indicator to represent patient skin dose.The gafChromic film results that the radiation dose to the skin for PTCA procedure greater than CA. In this study, we found a poor correlation of maximum entrance surface dose and total fluoroscopy time (R2 = 0.44 which were R2 = 0.26 for CA and R2 = 0.29 for PTCA). The result of gafChromic measurement shows that entrance surface dose for PTCA procedure greater than CA. For backscattering entrance dose, thyroid get the highest dose (1.45 cGy) followed by gonadal (1.05 cGy) and eyes (0.61 cGy)."

"Pada prosedur kardiologi intervensional pasien akan menerima radiasi primer berintensitas tinggi dari berkas utama sinar-X, sehingga dosis yang didapatkan cukup besar. Dengan demikian, perlu adanya studi distribusi dosis untuk melihat bagaimana penyebaran dosis pada organ-organ tubuh, dengan menggunakam film Gachromic XR-RV3 dan TLD 100 jenis rod yang telah diletakkan di dalam fantom Rando berbentuk manusia (wanita dewasa) sebagai pengganti pasien dengan parameter eksposi : kV rata-rata = 90 kV, laju frame = 15 fps, kuat arus = 6,2 mA dengan ukuran FPD = 15 cm x 15 cm. Distribusi laju dosis terbesar berada pada radius 0 cm sampai dengan 5 cm dari pusat lapangan, kemudian turun drastis pada radius 7,5 cm dan sudah tidak terdeteksi nilai laju dosis radius 10 cm. Untuk nilai laju dosis terbesar terdapat pada bagian pusat lapangan yaitu sebesar 6,345 ±0,097 mGy/min. Pada pengukuran laju dosis di beberapa Organ at Risk (OAR) dengan menggunakan Film Gafchromic XR-RV3 dan TLD 100 rod sebagai dosimeter didapatkan laju dosis pada Film Gachromic XR-RV3 dan TLD 100 rod dengan nilai terbesar terdapat pada organ jantung bagian tengah berturut-turut yaitu 2,742±0.029 mGy/min dan 2,791±0.161 mGy/min. Perbedaan nilai laju dosis antara Film Gachromic XR-RV3 dengan TLD 100 rod berkisar antara 0,53 % sampai dengan 13,80%.

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In interventional cardiology procedures patients will receive primary radiation of high intensity X-rays beam, so that dose received by the patient is relatively high. Thus, the dose distribution studies needed to see how the spread of the dose to the organs of the body, using Gachromic XR - RV3 film and TLD 100 type rod that has been placed in phantom Rando (adult women) as a replacement for a patient with parameters: average kV = 90 kV, frame rate = 15 fps, electric currents = 6.2 mA with FPD size = 15 cm x 15 cm. The distribution of the largest dose rate is at a radius of 0 cm to 5 cm from the center of the field, then dropped away at a radius of 7.5 cm and had no detectable dose rate value at radius of 10 cm. For the largest dose rate values are at the center of the field is about 6.345 ± 0.097 mGy / min. In the measurement of the dose rate in some organs at risk ( OAR ) using Gafchromic XR - RV3 film and TLD 100 rod obtained dose rate at Gachromic XR-RV3 film and TLD 100 rod with the largest value found in the central part of the heart organ ie 0.029 ± 2.742 mGy / min and 2.791 ± 0.161 mGy / min, respectively. The difference between the value of the dose rate Gachromic XR-RV3 film with TLD 100 rod ranged from 0.53% to 13.80%."

"Pada tindakan kardiologi intervensional, dosis yang diterima pasien relatif lebih tinggi, sedangkan pekerja radiasi akan menerima dosis hambur yang kualitasnya relatif lebih rendah. Namun, pekerja menerima dosis kumulatif dari seluruh tindakan kardiovaskuler yang dilakukannya selama bertahun-tahun. Oleh karenanya, tujuan penulisan ini akan difokuskan untuk mengestimasi distribusi radiasi hambur pada pekerja radiasi tanpa perisai pelindung di Cath Lab. Laju dosis hambur diukur menggunakan detektor survey unfors Xi. Detektor diletakkan pada 6 posisi berbeda di sekitar fantom. Setiap posisi memiliki sebelas titik pengukuran dari 25 sampai 175 cm di atas lantai dengan interval 15 cm, sebagai ilustrasi ketinggian parsial organ pekerja. Secara eksperimen, fantom rando diradiasi dengan fluoroskopi pada kondisi 88-93 kV dan 5.7-9.4 mA berdasarkan variasi kemiringan gantry dan ukuran lapangan. Phillips C-arm divariasikan pada Kemiringan gantri 0o PA projection, 20o dan 30o Caudal, 20o dan 30o Cranial, dan 40o dan 50o Left Anterior Oblique dan Flat Panel Detector (FPD) pada 20x20 dan 25x25 cm2. Secara umum, laju dosis tertinggi terdapat pada daerah pinggang pekerja (100 cm) dan terendah pada daerah kepala pekerja (175 cm) yaitu berturut-turut sebesar 2.49 mGv/jam dan 0.02 mGy/jam. Data pengamatan menunjukan bahwa fraksi hambur berada pada rentang 0.001–0.060% dari dosis primer di isocenter. Laju dosis hambur cenderung meningkat pada setiap peningkatan sudut kemiringan gantri di semua posisi. Semakin besar luas FPD maka akan menurunkan nilai fraksi dosis hambur yang juga akan meminimalkan laju dosis hamburnya.

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In Interventional Cardiology, dose received by the patient is relatively higher, while the occupational would receive scattered radiation dose whose quality is relatively lower. However, the occupational received accumulative doses of all cardiovascular procedures were done over the years. Therefore, the purpose of this paper will focus to estimate the distribution of scattered dose to occupational without any protective shielding in the Cath Lab. The scattered dose rate was measured by using survey detector of Unfors Xi. The detector was placed at 6 different positions around the phantom. Each measurement position has eleven points from 25 to 175 cm above the floor with increment of 15 cm as the illustration of partial height of occupational organ.

Experimentally a Rando phantom was irradiated by automatic pulsed fluoroscopy with condition varies in the range of 88-93 kV and 5.7-9.4 mA depend on gantry tilt and field size. The Phillips C-arm gantry tilt was varied at 0o PA projection, 20o and 30o Caudal, 20o and 30o Cranial, and 40o and 50o Left Anterior Oblique, and also Flat Panel Detector (FPD) was varied at 20x20 and 25x25 cm2. Generally, the greatest dose rate was known at level corresponding to Waist (100 cm) of occupational and the lowest at Head areas (175 cm) of occupational which is 2.49 mGv/h and 0.02 mGy/h, respectively. The given data showed that the scattered fractions are in the range of 0.001-0.060% from its primary dose at isocenter. The scattered doses tend to increase with gantry tilt for all positions. Increasing field size of FPD will decreased the scattered fraction from its dose at isocenter, and also it affects the scattered dose rate."

"Penggunaan angiografi dengan dosis tinggi memerlukan kendali mutu yang dilaksanakan oleh fisikawan medik klinis. Saat ini, AAPM telah memiliki protokol khusus kendali mutu angiografi, yakni AAPM Task Group 272. Sedangkan di Indonesia, protokol yang digunakan adalah Peraturan BAPETEN Nomor 2 tahun 2022 yang melingkupi seluruh jenis fluoroskopi. Karenanya, diperlukan studi komparasi kedua protokol untuk persiapan implementasi ke pesawat angiografi. Dalam penelitian ini, dilakukan pembandingan antara komponen uji di kedua protokol tersebut. Ditemukan bahwa komponen yang memiliki kemiripan metode adalah pengukuran dosis, baik laju dosis tipikal maupun laju dosis maksimum. Perbedaan di kedua protokol terdapat pada geometri pengukuran. Penelitian juga membandingkan pengaruh nilai lolos uji kedua protokol terhadap status kelolosan uji dari data sekunder berupa hasil uji kesesuaian dari CMPB LST FMIPA UI periode 2013-2018. Adaptasi protokol AAPM Task Group 272 dapat meningkatkan jumlah lolos uji sebanyak 21% karena telah mengakomodir sistem digital.

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The use of high-dose angiography requires quality control performed by clinical medical physicists. Currently, AAPM has a special protocol for angiography quality control, namely AAPM Task Group 272. Whereas in Indonesia, the protocol used is BAPETEN Regulation No. 2 of 2022 which covers all types of fluoroscopy. Therefore, a comparative study of the two protocols is needed to prepare for implementation into angiography aircraft. In this study, a comparison was made between the test components in the two protocols. It was found that the component that has similarity in method is dose measurement, both typical dose rate and maximum dose rate. The difference in the two protocols is in the measurement geometry. The study also compared the effect of the test pass value of the two protocols on the test pass status of secondary data in the form of conformity test results from CMPB LST FMIPA UI for the period 2013-2018. Adaptation of the AAPM Task Group 272 protocol can increase the number of test passes by 21% because it has accommodated digital systems."

"ABSTRAKPenelitian ini menggunakan Pesawat Angiografi Siemens Artis Zee untuk mengukur prosentase dosis kedalaman (Percentage Depth Dose, PDD) untuk mempelajari dosis di bawah kulit. Pengukuran PDD dilakukan dengan menggunakan film Gafchromic XR-RV3 yang diletakkan di antara fantom akrilik dengan 6 variasi filter pesawat, 5 variasi tegangan tabung, dan 3 variasi fokus berkas. Hasil penelitian menunjukkan karakteristik dosimetri yang didapatkan bersesuaian dengan teori, dimana titik kedalaman maksimum dan titik persentase dosis <10% semakin dalam dengan meningkatnya tegangan tabung dan filter tambahan, sementara ukuran fokus tidak memberikan pengaruh. Penelitian ini juga menunjukan bahwa dosis telah diserap sebesar lebih dari 69% oleh tubuh pada kedalaman 150 mm. Disimpulkan juga bahwa film Gafchromic XR-RV3 tidak dapat digunakan dalam pengukuran PDD angiografi dengan posisi permukaan tegak lurus berkas karena faktor buildup. Karenanya, diperlukan studi tambahan untuk menginvestigasi kedalaman buildup pada film Gafchromic XR-RV3 untuk keperluan pengukuran PDD.

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ABSTRACTThis study used Siemens Artist Zees Angiography to measure the percentage of depth dose (PDD) to investigate dose behaviour under the skin in angiography. The PDD measurements were carried out using the Gafchromic XR-RV3 film positioned between acrylic phantoms with 6 variations of added filtrations, 5 variations in tube voltage, and 3 variations in beam focal spot sizes. The results showed that the dosimetry characteristics obtained were in accordance with the theory, where the maximum depth point and point of <10% dose went deeper with the increase of tube voltage and additional filters, and with the focal spot size having no effect. Results also shown that dose were absorbed by more than 69% by the body at 150 mm depth. It was also concluded that the Gafchromic XR-RV3 film may not be ideal in measuring PDD for angiography with the position of the film perpendicular to the beam, i.e due to horizontal buildup factor. Therefore, additional studies are required to investigate the buildup depth in Gafchromic XR-RV3 film for PDD measurement purposes."