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"Penelitian ini bertujuan untuk membandingkan kualitas dari perencanaan terapi menggunakan conformity index (CI) dan homogeneity index (HI) pada kasus kanker paru-paru. Dengan menggunakan 5 pasien kanker paru-paru yang berada pada paru kanan. Dilakukan evaluasi pengaruh dari dose grid, kalibrasi densitas elektron berdasarkan fan beam dan cone beam CT. Hasil dari penelitian ini menunjukkan pasien dengan volume target berukuran besar memiliki kecenderungan CI yang rendah dan HI yang tinggi. Pada penggunaan variasi grid dose, nilai CI dan HI masing-masing kurang dari 0.02 dan 0.013. Perbedaan perhitungan antara cone beam dan fan beam adalah 10% untuk CI dan 60% untuk HI.

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This research aims to compare the quality of planning by using conformity index (CI) and homogeneity index (HI) for lung cancer cases. We used 5 lung cancer patients which is located in right lung. We evaluated the impact of dose grid, eletron density calibration based on fan beam and cone beam CT.

The results of shows the patient with big size target volume has tendency low CI value and high HI. On the use of grid dose variation, the CI and HI values less than 0.02 dan 0.013, respectively. The differences between the cone beam and fan beam calculation was 10% for CI and 60% for HI."

"[Telah dilakukan penelitian dalam mengevaluasi pengaruh material homogen dan inhomogen pada teknik IMRT (Intensity Modulated Radiotherapy) menggunakan modalitas Fan Beam CT (FBCT) dan Cone Beam CT (CBCT) terhadap Gamma Index (GI). Perencanaan ulang dilakukan untuk 5 pasien kanker paru kanan pada modalitas FBCT dan CBCT menggunakan TPS Phillips Pinnacle energi foton 6 MV. Menggunakan Teknik IMRT 30 segmen, 50 segmen, dan 70 segmen untuk perencanan terapi. Calculation Grid Resolution (CGR) 0.2 cm dan 0.4 cm digunakan sebagai resolusi dalam perhitungan dosis. Serta kalibrasi bilangan CT (KBC) FBCT, CBCT, dan linear dipergunakan sebagai koreksi CT density number. Pengukuran plannar dose untuk evaluasi Gamma Index (DD 2% / DTA 2 mm, passing rate 90%) dilakukan pada SAD 100 cm dengan material homogen dan inhomogen pada kedalaman 1.5 cm, 5 cm, dan 10 cm. Didapatkan deviasi nilai rata-­‐rata GI antara CGR 0.2 cm dengan 0.4 cm material homogen modalitas FBCT dan CBCT berturut-­‐tutut ≤1.46% dan ≤ 1.13%. Serta deviasi pada material inhomogen sebesar ≤ 2.54% (FBCT) dan ≤ 1.74% (CBCT). Deviasi Nilai rata-­rata GI antara FBCT dengan CBCT dengan CGR 0.2 cm berturut-­turut ≤ 1.95% (homogen) dan ≤ 2.36% (inhomogen). Dan deviasi Nilai rata-­‐rata GI antara material homogen dan material ekuivalen homogen sebesar ≤ 0.80%. Dari hasil penelitian yang didapat, bahwa evaluasi Gamma Index dapat dipengaruhi oleh jumlah segmen, modalitas CT, kalibrasi bilangan CT, Calculation Grid Resolution, dan kedalaman material.

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These Studies have been carried out to evaluate the effect of a homogeneous and inhomogeneous material on IMRT Technique (Intensity Modulated Radiotherapy) using Fan Beam CT (FBCT) and Cone Beam CT (CBCT) for the Gamma Index (GI). The Phillips Pinnacle treatment plan was used to replan 5 patients on right side of lung cancer. Photon 6 MV was applied to this technique with 30 segments, 50 segments, and 70 segments, repectively. Using Calculation Grid Resolution (CGR) 0.2 cm and 0.4 cm for resolution in the calculation of the dose. As well as the calibration of CT numbers (CCN) FBCT, CBCT, and the linear density are used as a correction CT number. The planar measurement for the evaluation of Gamma Index (DD 2% / DTA 2 mm, the passing rate of 90%) carried out at 100 cm SAD with the homogeneous and inhomogeneous material at a depth of 1.5 cm, 5 cm, and 10 cm, respectively. We obtained deviation average value of GI between CGR 0.2 cm and 0.4 cm using the homogeneous material on FBCT and CBCT modality ≤1.46% and ≤ 1:13%, respectively. As well as the material inhomogeneous deviation of ≤ 2.54% (FBCT) and ≤ 1.74% (CBCT). The deviation of the average GI value between FBCT with CBCT with CGR 0.2 cm respectively ≤ 1.95% (homogeneous) and ≤ 2.36% (inhomogeneous). Finally, the deviation of the average GI value between homogeneous and equivalent of homogeneous material is ≤ 0.80%. From the results obtained, that the Gamma Index can be influenced by the number of segments, modalities of CT, calibration of CT numbers, calculation grid resolution and depth of material.

, These

Studies

have

been

carried

out

to

evaluate

the

effect

of

a

homogeneous

and

inhomogeneous

material

on

IMRT

Technique

(Intensity

Modulated

Radiotherapy)

using

Fan

Beam

CT

(FBCT)

and

Cone

Beam

CT

(CBCT)

for

the

Gamma

Index

(GI).

The

Phillips

Pinnacle

treatment

plan

was

used

to

replan

5

patients

on

right

side

of

lung

cancer.

Photon

6

MV

was

applied

to

this

technique

with

30

segments,

50

segments,

and

70

segments,

repectively.

Using

Calculation

Grid

Resolution

(CGR)

0.2

cm

and

0.4

cm

for

resolution

in

the

calculation

of

the

dose.

As

well

as

the

calibration

of

CT

numbers

(CCN)

FBCT,

CBCT,

and

the

linear

density

are

used

as

a

correction

CT

number.

The

planar

measurement

for

the

evaluation

of

Gamma

Index

(DD

2%

/

DTA

2

mm,

the

passing

rate

of

90%)

carried

out

at

100

cm

SAD

with

the

homogeneous

and

inhomogeneous

material

at

a

depth

of

1.5

cm,

5

cm,

and

10

cm,

respectively.

We

obtained

deviation

average

value

of

GI

between

CGR

0.2

cm

and

0.4

cm

using

the

homogeneous

material

on

FBCT

and

CBCT

modality

≤1.46%

and

≤

1:13%,

respectively.

As

well

as

the

material

inhomogeneous

deviation

of

≤

2.54%

(FBCT)

and

≤

1.74%

(CBCT).

The

deviation

of

the

average

GI

value

between

FBCT

with

CBCT

with

CGR

0.2

cm

respectively

≤

1.95%

(homogeneous)

and

≤

2.36%

(inhomogeneous).

Finally,

the

deviation

of

the

average

GI

value

between

homogeneous

and

equivalent

of

homogeneous

material

is

≤

0.80%.

From

the

results

obtained,

that

the

Gamma

Index

can

be

influenced

by

the

number

of

segments,

modalities

of

CT,

calibration

of

CT

numbers,

calculation

grid

resolution

and

depth

of

material.

Key

words

:

Calculation

Grid

Resolution,

Calibration

of

CT

Numbers,

Cone]"

"Citra yang dihasilkan dari teknologi pencitraan flat panel yang terintegrasi dengan pesawat LINAC adalah kV-CBCT utamanya digunakan untuk verifikasi posisi pasien secara volumetric. Oleh karena itu, citra volumetrik dapat dibuatkan perencanaan ulang di Radioterapi. Perencanaan radioterapi berdasarkan citra volumetric kV-CBCT dilakukan dengan mengunakan acuan kurva kalibrasi dari CIRS 062M dan membandingkan dengan citra yang dihasilkan Fan Beam CT dari GE BrightSpeed. Evaluasi dilakukan pada organ pelvis dan organ kepala masing-masing sebanyak 5 pasien. Dosis yang dihasilkan Treatment Planning System berbasis citra Fan Beam CT menjadi acuan dalam penelitian ini. Hasil dosis citra kV-CBCT menunjukkan bahwa perbedaan dosis rata-rata Planning Target Volume (PTV) dan Organ At Risk di bawah 5% sedangkan untuk kasus organ kepala perbedaan dosis untuk PTV dan OAR adalah di atas 5%. Selain itu penilaian distribusi dosis melalui perangkat lunak verisoft 3.1 dilakukan menggunakan parameter dose to agreement (DTA) 2 mm dan dose difference 2% dengan nilai toleransi 90. Hasilnya untuk organ pelvis lolos namun tidak demikian untuk otgan kepala. Hal ini disebabkan fiksasi yang digunakan untuk immobilisasi organ kepala nilai densitasnya terhitung sama dengan jaringan tubuh manusia akibat dari artefak dan beam hardening yang dihasilkan oleh teknologi pencitraan kV-CBCT.

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The resulting image of the flat panel imaging technology that is integrated with the aircraft linac kV-CBCT is mainly used for the verification of the patient position volumetric. Therefore, the volumetric image can be re-created in radiotherapy planning. Radiotherapy planning based on kV-CBCT volumetric image is done by using a reference calibration curve of CIRS 062M and compare with the resulting image of Fan Beam CT GE BrightSpeed. Evaluation is done on the pelvic organs and organ head respectively by 5 patients.

The resulting dosebased Treatment Planning System Fan Beam CT image of a reference in this study. Results kV-CBCT dose images showed that the average dose difference Planning Target Volume (PTV) and organs at Risk under 5%, while in the case of organ head difference for the PTV and OAR dose is above 5%. In addition to the assessment of dose distributions through 3.1 software verisoft done using parameter dose to agreement (DTA) 2 mm and dose difference of 2% with a tolerance value of 90. The result for the pelvic organs slip but not so for otgan head. This is due to the fixation of the organs used for immobilizing the head value equal to the calculated density of body tissue and the effect of beam hardening artifacts produced by the kV-CBCT imaging technology."

"ABSTRAKDalam perencanaan terapi teknik lanjut telah diimplementasikan algoritma Anisotropic Analytical Algorithm AAA dan Acuros XB pada perencanaan terapi dengan teknik IMRT dan VMAT. Dalam penelitian ini dimaksudkan untuk memverifikasi simulasi perencanaan terapi dan pemberian dosis IMRT dan VMAT pada kasus kanker prostat dan kanker paru. Verifikasi dosis dilakukan dengan meletakkan TLD 100 LiF rod dan film Gafchromic EBT3 pada fantom Rando Alderson. Evaluasi dosis dilakukan dengan membandingkan analisis dosimetri PTV dan organ at risk menggunakan algoritma Anisotropic Analytical Algorithm AAA dan Acuros XB pada teknik IMRT dan VMAT. Dari hasil penelitian PTV pada kanker prostat algoritma Acuros XB memiliki kualitas perencanaan lebih baik dibandingkan Anisotropic Analytical Algorithm AAA sebesar 1 . Pola yang sama juga diperoleh organ at risk dengan algoritma terbaik diperoleh Acuros XB dengan penyimpangan rata-rata terbesar pada OAR femoral head sebesar 6 . Lebih lanjut PTV pada kanker paru kiri dan kanan memiliki penyimpangan rata-rata lebih kecil pada teknik VMAT. Sementara pada penggunaan algoritma Acuros XB memiliki kualitas perencanaan lebih baik dibandingkan Anisotropic Analytical Algorithm AAA sebesar 0,56 . Pada OAR kasus paru kiri dan kanan tidak terdapat perbedaan yang signifikan dari penggunaan algortima Acuros XB dan Anisotropic Analytical Algorithm AAA dengan rentang deviasi terbesar diperoleh jantung 9.

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ABSTRACTIn the planning of advanced engineering therapy has been implemented Anisotropic Analytical Algorithm AAA and Acuros XB algorithms on therapy planning with IMRT and VMAT techniques. In this study intended to verify the simulation of therapy planning and dosage of IMRT and VMAT in cases of prostate cancer and lung cancer. Dose verification is done by placing TLD 100 LiF rod and Gafchromic EBT3 film on fantom Rando Alderson. Dose evaluation was done by comparing dosimetry analysis of PTV and organ at risk using Anisotropic Analytical Algorithm AAA and Acuros XB algorithm on IMRT and VMAT techniques. From the results of research PTV on prostate cancer algorithm Acuros XB has better planning quality than Anisotropic Analytical Algorithm AAA of 1 . The same pattern is also obtained by the organ at risk with the best algorithm obtained by Acuros XB with the largest mean deviation on femoral head OAR of 6 . Furthermore, PTV in left and right lung cancer has a smaller mean deviation in VMAT technique. While the use of Acuros XB algorithm has better planning quality than Anisotropic Analytical Algorithm AAA of 0.56 . In the left and right lung OAR cases there was no significant difference from the use of the Acuros XB algorithm and the Anisotropic Analytical Algorithm AAA with the largest deviation range obtained by heart 9 . "

"Latar Belakang : Merokok masih merupakan masalah kesehatan utama di Indonesia. Merokok menjadi faktor risiko bagi penyakit kanker paru dan PPOK. Hubungan antara kanker paru dan PPOK masih terus dikaji. Komorbiditas PPOK pada kanker paru dapat mempengaruhi proses diagnostik, tatalaksana serta managemen akhir kehidupan pasien kanker paru.Metode : Penelitian ini adalah studi potong lintang analitik yang dilakukan di poliklinik onkologi paru RSUP Persahabatan selama periode Agustus 2018 sampai dengan April 2019 terhadap pasien kanker paru kasus baru yang telah memenuhi kriteria inklusi dan eksklusi.Hasil : terdapat 52 subjek yang diteliti dan didapatkan 76,9% adalah laki-laki dan perokok (71,2%), jenis kanker paru yang paling banyak ditemukan ialah kanker paru karsinoma bukan sel kecil (98,1%), sebagian besar stage 4 (88%) dan tampilan klinis 1 (50%). Prevalens PPOK berdasarkan pemeriksaan spirometri menurut kriteria PNEUMOMOBILE ialah 46,2% dan prevalens emfisema berdasarkan pemeriksaan CT-scan toraks ialah 30,8%.. Subjek kanker paru yang menderita PPOK 91,7% termasuk kedalam obstruksi derajat sedang (GOLD 2) serta memiliki kelainan faal paru campuran obstruksi dan restriksi ( 70,8%). Subjek yang menderita emfisema terbanyak menderita emfisema jenis sentrilobular (43,7%). Terdapat hubungan antara letak lesi sentral terhadap beratnya obstruksi yang diukur melalalui nilai VEP1 pada subjek PPOK dan emfisema.Kesimpulan : PPOK pada kanker paru terutama ditemukan pada laki-laki, perokok serta jenis kanker yang paling banyak diderita ialah adenokarsinoma. Emfisema yang paling banyak diderita ialah jenis sentrilobular yang secara umum banyak didapatkan pada perokok.

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Background: Smoking is one of risk factors in both of lung cancer and chronic obstructive pulmonary disease (COPD). Comorbidity of COPD among lung cancer patients generally influenced outcome of their quality of life, diagnostic procedures, treatments, and end of life managements.

Methods:This analytical cross-sectional study involved newly diagnosed lung cancer cases admitted to the oncology clinics of Persahabatan Hospital Jakarta, Indonesia between August 2018 and April 2019. Patients who met the study criteria were consecutively included. Spirometric evaluation of airway obstruction and COPD was based on PNEUMOBILE and GOLD criteria. Radiological evaluation of emphysema was based on thorax CT-scan.

Results:Subjects were 52 lung cancer patients and most of them were males (76.9%) and smokers (71.2%). Most of them were diagnosed as non-small cell lung cancer (NSCLC) (98.1%), were in end-stage of the disease (88.0%) and were in performance status of 1 (50.0%). The prevalence of COPD and emphysema was 46.2% and 30.8%, respectively. Most of the COPD subjects (91.7%) experienced moderate airway obstruction (GOLD 2), along with mixed obstruction-restriction spirometric results (70.8%). Centrilobular emphysema was common (43.7%) radiological finding in this study. Degree of obstruction by spirometry (VEP1)and detection of central tumor lesion by thorax CT-scan in COPD and emphysema subjects was found to be correlated.

Conclusion:COPD in lung cancer was found in males, smokers, and NSCLC patients. Centrilobular emphysema was commonly found in this study, particularly in smoker sub-group."

"Telah dilakukan penelitian pengukuran dosis titik (point dose) pada daerah target (paru-paru), jantung, dan tulang belakang menggunakan empat dosimeter (PTW N30013, Exradin A16, TLD, dan film Gafchromic EBT2). Tujuan utama dari penelitian ini adalah membandingkan keempat sistem dosimeter tersebut dalam hal akurasi, presisi, rentang pengukuran, serta resolusi spasial dan ukuran fisik. Pengukuran dosis dilakukan hanya pada satu kali fraksi penyinaran. Hasil pengukuran menunjukkan bahwa TLD memiliki akurasi dan presisi yang paling rendah. Adapun efek volume averaging pada bilik ionisasi menyebabkan nilai diskrepansi mencapai -13.30% pada daerah target. Sedangkan film EBT2, dengan nilai diskrepansi <1% pada 3D-CRT dan IMRT, dinyatakan sebagai dosimeter alternatif yang sesuai untuk digunakan pada verifikasi dosis titik.

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This research was conducted by measuring point dose in the target area (lungs), heart, and spine using four dosimeters (PTW N30013, Exradin A16, TLD, and the Gafchromic EBT2 film). The main objective of this study was to compare the dosimetry of those different systems. Dose measurements performed only in single fraction of irradiation. The measurement results shown that TLD has the least accuracy and precision. As the effect of the volume averaging, ionization chamber reaches the discrepancy value up to -13.30% in the target area. EBT2 film has discrepancy value of <1% in the 3D-CRT and IMRT techniques. This dosimeter is proposed to be an appropriate alternative dosimeter to be used at dose point verification."

"Penelitian ini bertujuan untuk mengevaluasi akurasi perhitungan dosis berdasarkan citra Cone Beam Computed Tomography (CBCT) sebagai adaptive planning. Perencanaan terapi radiasi dilakukan terhadap 3 pasien kanker laring, 7 pasien kanker paru dan 5 pasien kanker prostat dengan menggunakan teknik Intensity Modulated Radiotherapy (IMRT) dan Volumetric Modulated Arc Therapy (VMAT). Perhitungan dosis dilakukan pada TPS Eclipse v13.6 dengan variasi algoritma Analytical Anisotropic Algorithm (AAA) dan Acuros External Beam (AXB). Penelitian ini diawali dengan tahapan (1) kalibrasi HU citra CBCT menggunakan fantom CIRS 002LFC (2) analisa dose volume histogram (DVH), (3) analisa gamma index dengan kriteria DD 2% / DTA 2mm serta DD 3% / DTA 3mm menggunakan perangkat EPID. Penyimpangan D_98%, D_50% dan D_2% dari DVH dievaluasi dengan menjadikan citra CT algoritma AAA sebagai referensi. Diperoleh nilai penyimpangan D_98%, D_50% dan D_2% tertinggi pada kasus kanker laring yaitu sebesar 9,08% ± 2,21 (CBCT AXBm - CT AAA), 0,74% ± 0,37 (CBCT AXBw - CT AAA) dan 3,79% ± 0,55 (CBCT AXBw - CT AAA). Penyimpangan D_98%, D_50% dan D_2% pada kasus kanker paru dan kanker prostat diperoleh lebih kecil dari 2%. Conformity index (CI) diperoleh pada rentang 0,98 ± 0,011 dan homogeneity index (HI) diperoleh pada rentang 0,08 ± 0,015. Analisa gamma index dengan kriteria 2%/2mm diperoleh pada range 87% - 94% dan kriteria 3%/3mm diperoleh 93% - 99%. Dari hasil penelitian ini didapati bahwa hasil kalkulasi dosis berdasarkan citra CBCT hampir sama dibandingkan dengan citra FBCT sehingga citra CBCT dilihat layak digunakan sebagai adaptive planning radiotherapy.  

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The purpose of this study was to evaluate the accuracy of dose calculation based on Cone Beam Computed Tomography (CBCT) as adaptive planning. Treatment planning was generated for 3 patients larynx, 7 patients lung and 5 patients prostate using Intensity Modulated Radiotherapy (IMRT) and Volumetric Arc Therapy (VMAT). Eclipse v13.6 treatment planning system (TPS) with Analytical Anisotropic Algorithm (AAA) and Acuros External Beam (AXB) algorithm has been used to calculate the dose.

This study was divided into three major parts : (1) HU calibration for CBCT images by using CIRS phantom 002LFC (2) dose volume histogram (DVH) analysis, (3) analysis of Gamma Passing Rate with criteria DD 2% / DTA 2mm and DD 3% / DTA 3mm using EPID. The DVH analysis for D_98%, D_50% dan D_2% deviation was evaluated and CT images with AAA algorithm used as reference. The highest deviation of D_98%, D_50% dan D_2% was found for larynx cancer with value  9,08% ± 2,21 (CBCT AXBm - CT AAA), 0,74% ± 0,37 (CBCT AXBw - CT AAA) and 3,79% ± 0,55 (CBCT AXBw - CT AAA).

Deviation of D_98%, D_50% dan D_2% for lung and prostate cancer is less than 2%. Range of conformity index based on CBCT images is 0,98 ± 0,011 and homogeneity index is in the range of 0,08 ± 0,015. The gamma criteria of dose difference and dose to agreement for 2%/2mm are 87% - 94% and for 3%/3mm are 96% - 98%. From the result, we found that the difference of dose calculation based on CBCT images is almost similar to CT images, so CBCT images are proper to be used for adaptive planning."

"ABSTRAKPerencanaan radioterapi dilakukan untuk mendapatkan hasil rasio terapeutik yang optimal. Untuk mencapai hal tersebut diperlukan perhitungan distribusi dosis yang akurat, dan hal tersebut secara signifikan dipengaruhi oleh inhomogenitas jaringan. Oleh karena itu, penelitian ini dilakukan untuk mengetahui perbandingan antara perencanaan radioterapi 3D-CRT, IMRT, dan SBRT berdasarkan citra terkalibrasi kurva bilangan CT menggunakan Fantom CIRS Model 062M, Fantom CIRS Model 002LFC, dan kurva kalibrasi bilangan CT Linier pada organ paru-paru untuk bentuk target silinder, setengah silinder, dan konkaf ‘C’ pada teknik 3D-CRT dan IMRT, serta sumsum tulang belakang untuk teknik SBRT. Kurva kalibrasi bilangan CT dimasukkan ke dalam TPS Pinnacle3, kemudian perencanaan radioterapi dilakukan untuk teknik 3D-CRT, IMRT dengan 7 lapangan radiasi, dan SBRT dengan 15 lapangan radiasi. Evaluasi dilakukan dengan membandingkan kurva DVH, indeks homogenitas, dan indeks konformitas. Pada perencanaan 3D-CRT dan IMRT dihasilkan indeks homogenitas terbaik pada kurva kalibrasi CIRS Model 002LFC dengan nilai 0.243 dan 0.1007. Sedangkan untuk SBRT, indeks homogenitas terbaik pada kurva kalibrasi linier dengan nilai 0.361. Indeks konformitas terbaik pada teknik IMRT dan SBRT didapatkan dengan menggunakan kurva kalibrasi linier yakni sebesar 0.974 dan 1.770, sedangkan untuk 3D-CRT didapatkan pada kurva kalibrasi CIRS Model 062M yakni sebesar 0.452. Dari hasil nilai indeks konformitas dan indeks homogenitas tersebut, maka dapat disimpulkan bahwa kurva kalibrasi bilangan CT yang digunakan dalam penelitian tidak berbeda jauh dengan literatur yakni kurva kalibrasi Schneider.

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ABSTRACTRadiotherapy planning is performed to achieve the optimal therapeutic ratio. For that purpose, accurate calculation of the dose distribution is required, and the calculation is significantly affected by inhomogeneity tissue. This study was performed to determine the ratio between radiotherapy treatment planning using 3D-CRT, IMRT, and SBRT technique based on a calibrated curve of CT-number using Phantom Density Electron CIRS Model 062M, Phantom Thorax CIRS Model 002LFC, and linear calibration curve of CT-number in lung for cylindrical target, half cylinder and concave “C” in 3D-CRT, IMRT, and spinal cord for SBRT. Calibration curves of CT-number was generated under measurement basis and introduced into TPS Pinnacle3, then radiotherapy planning was performed for 3D-CRT, and IMRT technique with 7 radiation fields, and SBRT with 15 radiation fields. Afterwards, planning evaluation was performed by comparing the DVH curve, homogeneity index, and conformity index. 3D-CRT and IMRT technique produced the lowest homogeneity index at calibration curve of CIRS Model 002LFC with the value 0.243 and 0.1007. Whereas SBRT produced the lowest homogeneity index on a linear calibration curve with a value of 0.361. The highest conformity index in IMRT and SBRT technique achieved using a linear calibration curve was 0.974 and 1.770 respectively. For 3D-CRT, the highest conformity index was obtained by using calibration curve of CIRS Model 062M with the value of 0.452. From the results of conformity index and homogeneity index, it is concluded that the calibration curve of CT-number used in this study does not significantly differ with available literature (Schneider’s calibrated curve)."

"This title covers the use of high-res computed tomography for diagnosis and assessment of diffuse lung diseases. This reference offers a thorough grounding in HRCT interpretation, offering the latest technical and clinical data, including recent advances in the classification and understanding of diffuse lung diseases and their HRCT appearances.Looking for the seminal guide to HRCT and lung abnormalities? Get the newly revised and updated 5th edition of High-Resolution CT of the Lung, the leading reference on the use of high-res computed tomography for diagnosis and assessment of diffuse lung diseases. Written by leading experts in the field, this comprehensive reference offers a thorough grounding in HRCT interpretation, offering the latest technical and clinical data, including recent advances in the classification and understanding of diffuse lung diseases and their HRCT appearances.Features: new: full-color illustrations of histo."

"[Teknik radioterapi lapangan kecil memiliki tingkat kerumitan yang tinggi, karena keberhasilan pelaksanaan terapi menggunakan teknik ini sangat bergantung pada keakuratan proses mulai dari perencanaan, pemberian dosis selama terapi hingga evaluasi pengukuran dosis terapi. Penelitian ini dilakukan pada kasus kanker paru menggunakan teknik lapangan kecil pada kasus teknik IMRT dan SBRT dimana evaluasi dosis dilakukan dengan menggunakan bilik ionisasi, TLD ,dan film gafchromic EBT2. Nilai diskrepansi yang didapatkan pada teknik IMRT menggunakaan film memiliki nilai yang paling kecil diantara dosimeter lainnya yaitu berada pada rentang nilai 1,75% ~ -0,60%. Pengukuran SBRT baik pada RSCM maupun RSGP hasil yang ditunjukkan PTW 300013 menunjukkan nilai diskrepansi yang tinggi yaitu pada rentang -7,08% ~ -14,98%. Berbanding terbalik dengan PTW 300013, dosimeter Exradine A16 menunjukkan nilai diskrepansi yang kecil yaitu -2,96% ~ -4,12%. Hasil evaluasi film menggunakan MATLAB pada teknik IMRT menghasilkan nilai dosis terukur ≥ 4% lebih tinggi dibandingkan dengan film QAProTM. Sedangkan unutk nilai SBRT dosis terukur yang dihasilkan oleh MATLAB ≤ 4% lebih rendah dibandingkan film QAProTM . Hasil evaluasi dosis dari bilik ionisasi baik pada pengukuran langsung maupun evaluasi menggunakan MATLAB menunjukkan pola yang serupa, yaitu bernilai overestimate pada IMRT dan underestimate pada SBRT.;Small field radiotherapy techniques have a high level of complexity, due to the successful of this implementation is highly dependent on the accuracy of the process from planning until evaluating the dose measurement. This research was done in the case of lung cancer using small field radiotherapy by using IMRT and SBRT technique. The dose evaluation is done by using ionization chambers, TLD, and the gafchromic EBT2 film. Results of discrepancy value in IMRT techniques using film has the smallest value among other dosimeters, in range 1.75% to -0.60%. PTW 300 013 shows a high value of discrepancies on the SBRT measurement, in the range of -7.08% to -14.98%. In contrast with PTW300013, Exradine A16 shows a low value of discrepancies, in range -2,96% to -4,12%. Results of film evaluation using MATLAB, IMRT technique have measurable dose value 4% higher than the film QAProTM. Dose discrepancy of SBRT technique that generated by MATLAB 4% lower than the film QAProTM. The Results of dose evaluation using ionization chamber both of measurement and MATLAB evaluation showed a similar pattern, which is have the overestimate value in IMRT and underestimate value in SBRT., Small field radiotherapy techniques have a high level of complexity, due to the successful of this implementation is highly dependent on the accuracy of the process from planning until evaluating the dose measurement. This research was done in the case of lung cancer using small field radiotherapy by using IMRT and SBRT technique. The dose evaluation is done by using ionization chambers, TLD, and the gafchromic EBT2 film. Results of discrepancy value in IMRT techniques using film has the smallest value among other dosimeters, in range 1.75% to -0.60%. PTW 300 013 shows a high value of discrepancies on the SBRT measurement, in the range of -7.08% to -14.98%. In contrast with PTW300013, Exradine A16 shows a low value of discrepancies, in range -2,96% to -4,12%. Results of film evaluation using MATLAB, IMRT technique have measurable dose value 4% higher than the film QAProTM. Dose discrepancy of SBRT technique that generated by MATLAB 4% lower than the film QAProTM. The Results of dose evaluation using ionization chamber both of measurement and MATLAB evaluation showed a similar pattern, which is have the overestimate value in IMRT and underestimate value in SBRT.]"