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"[ABSTRAKDosimetri CT scan dapat dilakukan dengan menggunakan konsep CTDI, MonteCarlo, atau dengan pengukuran langsung dalam fantom fisis. Pengukuranlangsung menggunakan thermoluminescent dosimeter (TLD) merupakan proseduryang rumit dan membutuhkan waktu yang lama. Saat ini sudah tersedia filmradiochromic yang dapat digunakan di radiologi. Pada penelitian ini dilakukanpengukuran distribusi dosis radiasi dalam fantom Rando menggunakan filmGafchromic XR-QA2 dan TLD. Film Gafchromic XR-QA2 dan TLD dikalibrasidi CT scanner Siemens Sensation 64. Pengukuran distribusi dosis dengan filmdilakukan pada faktor pitch 0.8, 1.0, dan 1.4. Film Gafchromic XR-QA2disisipkan diantara slab 22-23 (Film A), 23-24 (Film B), dan slab 24-25 (Film C).Pengukuran distribusi dosis dengan TLD dilakukan dalam slab nomor 23 denganfaktor pitch 1.4. Film Gafchromic XR-QA2 yang telah dieksposi dipindai denganflatbed scanner Epson Perfection V700 Photo. Dosis serap tulang belakang padaFilm A, Film B, dan Film C yang dieksposi dengan faktor pitch 1.4 secaraberturut-turut adalah 2.0 mGy, 1.9 mGy, dan 2.2 mGy. Berdasarkan profil dosis,rata-rata dosis serap pada film yang dieksposi dengan faktor pitch 1.0 dan 1.4secara berturut-turut adalah 8% dan 24% lebih tinggi dibanding rata-rata dosisserap pada film yang dieksposi dengan faktor pitch 0.8. Rentang dosis hasilpengukuran dengan TLD adalah (1.9 ± 0.1) – (2.3 ± 0.2) mGy dan rentang dosishasil pengukuran dengan film Gafchromic XR-QA2 adalah 1.8 – 2.3 mGy denganperbedaan maksimum 10.6%. Perbedaan tersebut masih berada dalam rentangkeakurasian TLD yaitu < 15%. Berdasarkan hasil tersebut, film Gafchromic XRQA2dapat digunakan untuk pengukuran dosis CT scan selanjutnya.

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ABSTRACTComputed tomography (CT) dosimetry can be approached by using CTDImethod, Monte Carlo computer technique, and direct measurement withinphysical phantom. Direct measurement using thermoluminescent dosimeters(TLDs) is a laborious procedure. Radiochromic film for radiology application wasavailable. In this study, dose distribution within adult anthropomorphic physicalphantom was measured using TLD and Gafchromic XR-QA2 film. TLD andGafchromic XR-QA2 film was calibrated on CT scanner Siemens Sensation 64.Gafchromic XR-QA2 film was sandwiched between slab Rando phantom number22-23 (Film A), 23-24 (Film B), and 24-25 (Film C). Pitch factor 0.8, 1.0, and 1.4were used. TLDs were placed at the holes in the slab number 23 ofanthropomorphic phantom. TLDs were scanned using pitch factor 1.4. Afterexposure, Gafchromic XR-QA2 film was digitized using Epson Perfection V700Photo flatbed scanner. Absorbed dose at vertebra on Film A, Film B, and Film Cwhich exposed by using pitch 1.4 respectively were 2.0 mGy, 1.9 mGy, and 2.2mGy. Based on dose profile, average dose of XR-QA2 film which exposed byusing pitch 1.0 and 1.4 respectively were 8% and 24% higher than average dose ofXR-QA2 film which exposed by pitch 0.8. TLDs dose range were (1.9 ± 0.1) –(2.3 ± 0.2) mGy and Gafchromic XR-QA2 film dose range were 1.8 – 2.3 mGywith maximum difference 10.6%. The difference is still within the range of TLDaccuracy, < 15%. Based on this result, Gafchromic XR-QA2 film can be used tomeasure CT dose, Computed tomography (CT) dosimetry can be approached by using CTDImethod, Monte Carlo computer technique, and direct measurement withinphysical phantom. Direct measurement using thermoluminescent dosimeters(TLDs) is a laborious procedure. Radiochromic film for radiology application wasavailable. In this study, dose distribution within adult anthropomorphic physicalphantom was measured using TLD and Gafchromic XR-QA2 film. TLD andGafchromic XR-QA2 film was calibrated on CT scanner Siemens Sensation 64.Gafchromic XR-QA2 film was sandwiched between slab Rando phantom number22-23 (Film A), 23-24 (Film B), and 24-25 (Film C). Pitch factor 0.8, 1.0, and 1.4were used. TLDs were placed at the holes in the slab number 23 ofanthropomorphic phantom. TLDs were scanned using pitch factor 1.4. Afterexposure, Gafchromic XR-QA2 film was digitized using Epson Perfection V700Photo flatbed scanner. Absorbed dose at vertebra on Film A, Film B, and Film Cwhich exposed by using pitch 1.4 respectively were 2.0 mGy, 1.9 mGy, and 2.2mGy. Based on dose profile, average dose of XR-QA2 film which exposed byusing pitch 1.0 and 1.4 respectively were 8% and 24% higher than average dose ofXR-QA2 film which exposed by pitch 0.8. TLDs dose range were (1.9 ± 0.1) –(2.3 ± 0.2) mGy and Gafchromic XR-QA2 film dose range were 1.8 – 2.3 mGywith maximum difference 10.6%. The difference is still within the range of TLDaccuracy, < 15%. Based on this result, Gafchromic XR-QA2 film can be used tomeasure CT dose]"

"Retur obat dan alat kesehatan sering terjadi pada pasien rawat inap. Rata-rata retur RS Royal Taruma tahun 2016 sekitar 10% dari transaksi penjualan. Penelitian bertujuan mencari faktor penyebab, dampak dan permasalahan retur dengan desain penelitian studi kasus secara kualitatif dan kuantitatif atas transaksi retur April 2017. Berdasarkan penelitian, penyebab retur dibagi menjadi faktor penyebab dari pasien (3,1%), dokter (63,1%) yaitu pasien pulang (33%), penghentian/ penggantian terapi (30,1%) serta faktor internal (33,8%) yang berhubungan dengan SDM, prosedur, sistem informasi dan pengawasan. Permasalahan retur dan ketidakefisien sistem informasi mengakibatkan pemborosan waktu, biaya sehingga disarankan untuk memperbaiki sistem distribusi obat dan sistem informasi.Medications and disposable medical equipment returned are common in hospitalized patients. The average of medications return at Royal Taruma Hospital in 2016 is about 10% of sales transactions. The purpose of the research is to find the causal factors, impacts and problems of medication returned applying case study designs with qualitative and quantitative data on the return transactions of April 2017. Based on the research, the causes were divided into factors of the patient (3.1%), physician (63.1%) consist of returning patients (33%), discontinuation/replacement therapy (30.1%) and internal factor (33.8%) related to human resources, procedures, information systems and supervision. Problems of returns and inefficiencies of information systems lead to waste of time, costs. It is advisable to improve drug distribution systems and information systems."

"Suatu penelitian telah dilakukan untuk menemukan hubungan antara presentasi hamburan dengan variasi sudut hambur dalam ruang fluoroskopi dan bagaimana hal tersebut berpengaruh terhadap hamburan yang diterima oleh organ personil fluoroskopi. Penelitian dilakukan dengan mengukur dosis hambur menggunakan keping TLD (Thermoluminescent Dosimeter) LiF yang ditempelkan pada pusat phantom yang diletakkan di tengah meja pemeriksaan fluoroskopi. TLD juga ditempatkan pada 7 (tujuh) lokasi di depan meja dengan sudut yang berbeda dengan menggunakan tali yang terpasang 50 cm dari phantom. Pengukuran ini dibandingkan dengan pengukuran hamburan yang diterima oleh organ personil fluoroskopi dengan menempelkan TLD pada dahi, leher, dada, pinggang, dan kaki personil saat mereka melakukan tindakan fluoroskopi terhadap pasien. Hasil menunjukkan bahwa jumlah hamburan tergantung pada sudut hambur dan presentasi dosis hambur ke arah atas lebih besar dari pada yang ke arah bawah. Hal ini memberikan informasi bagi personil fluoroskopi bahwa dalam prosedur fluoroskopi dengan tabung di atas, bagian atas tubuh personil akan lebih banyak menerima dosis hambur sehingga mereka harus peduli terhadap pemakaian perisai radiasi pada organ vital bagian atas seperti mata dan tiroid. Personil juga harus mempertimbangkan posisi mereka sehingga paparan organ personil fluoroskopi dapat dijaga pada tingkat yang diharapkan. ......A Study was conducted to investigate the relation of percentages scatter with variation scatter angle in fluoroscopy room and how it affect to the scatter received by fluoroscopist's organ. The scatter dose was measured by using LiF TLD (Thermoluminescent Dosimeter) chips located on the center of a phantom, which was placed on the center of a fluoroscopy table. TLDs were also put on 7 (seven) different locations in front of the table with different angles by using strings at a distance of 50 cm from the phantom. This measurement have been compared with measurement of the scatter received by attaching TLD to fluoroscopist's forehead, neck, thorax, waist, and foot while operating fluoroscopy equipment on patients. The results showed that the amount of scatter depend on the angle scatter, and the percentages of scatter dose in the backward direction are higher than percentages of scatter dose in the forward direction. The results give information to fluoroscopists that the upside of their body will receive more scatter dose, so they must care about using shielding on their vital organ like eyes and tyroid. Fluoroscopists also must consider their position so that the fluoroscopist's organ exposure can be maintained at an acceptable level."

"Telah dilakukan penelitian untuk memperoleh distribusi dosis sumber brakiterapi Ir-192 HDR (High Dose Rate) Mikroselektron Klasik dalam medium air dengan Monte Carlo EGSnrc. Parameter dosis dikalkulasi sesuai dengan rekomendasi AAPM TG 43 seperti: kekuatan kerma udara, konstanta laju dosis, fungsi dosis radial, dan fungsi anisotropi. Hasil kalkulasi diperoleh nilai kekuatan kerma udara (Sk/A) sebesar 9,65 x 10-8 U.Bq-1 dengan nilai konstanta laju dosis (Λ) sebesar 1,121 cGy h-1 U-1. Dalam klinis, brakiterapi umumnya menggunakan distribusi dosis dari multi sumber. Distribusi dosis tersebut sangat ditentukan oleh interval antar sumber. Dengan mengambil referensi dosis di titik sumbu utama pada jarak 1,0 cm dari sumber maka distribusi dosis mulai tidak homogen bila interval antar sumber ≥ 1,5 cm terutama untuk r ≤ 1,0 cm. ......This study presents the results of EGSnrc Monte Carlo calculations of the dose distribution of Ir-192 brachytherapy HDR (High-Dose Rate) Microselectron Classic sources in water medium. Parameters of dose were calculated according to AAPM TG 43 recommendations such as air kerma strength, dose rate constant, radial dose function and anisotropy function. The results of calculations obtained air kerma strength (Sk/A) of 9.65 x 10-8 U.Bq-1 with dose rate constant (Λ) of 1.121 cGy.h-1.U-1. In clinical, brachytherapy generally used dose distribution from multi-sources. The dose distribution is mostly determined by the interval between sources. By taking reference dose at the point of the main axis at a distance of 1.0 cm from the source dose distribution started not homogeneous when the interval between sources ≥ 1.5 cm especially for r ≤ 1.0 cm."

"Teknik Cone Beam Computed Tomography (CBCT) dalam pemindaian 3DRA menggunakan sinar-X berbentuk kerucut bulat atau persegi panjang dengan rotasi pemindaian yang tidak mencapai 360 derajat. Sementara itu, metode perhitungan dosimetri 3DRA saat ini masih mengacu pada konsep CTDI, hal ini mungkin tidak sesuai untuk dosimetri CBCT karena sudut pancaran cone yang lebih besar dibandingkan dengan sudut pancaran fan beam dan rotasi pemindaian 3DRA yang tidak mencapai 360 derajat. Penelitian ini bertujuan untuk menganalisis distribusi dosis pada simulasi dan pengukuran dalam pemindaian Angiografi Rotasi Tiga Dimensi (3DRA). Metode yang digunakan melibatkan perbandingan hasil simulasi distribusi dosis menggunakan perangkat lunak EGSnrc dengan hasil pengukuran pada pesawat Angiografi Phillips Allura FD20 (tiga mode pemindaian) menggunakan bilik ionisasi. Proses simulasi menggunakan perangkat lunak EGSnrc terdiri dari tiga tahap. Pertama, lima fantom CTDI virtual dibuat untuk merepresentasikan lubang sesuai dengan penempatan dosimeter pada posisi yang berbeda (pusat, arah jam 3, 6, 9, dan 12). Ukuran voxel fantom disesuaikan menjadi 1 × 1 × 1 mm². Tahap kedua melibatkan pemodelan dan simulasi tabung sinar-X pada sistem 3DRA menggunakan perangkat lunak BEAMnrc. Terakhir, dilakukan simulasi penyinaran pada fantom virtual menggunakan perangkat lunak DOSXYZnrc. Jumlah histories untuk simulasi ditetapkan menjadi 2.5×108, nilai energi cutoff diatur pada 0,521 MeV untuk transportasi elektron, dan 0,001 MeV untuk transportasi foton. Hasil penelitian menunjukkan bahwa area yang paling banyak terpapar radiasi pada ketiga mode 3DRA terletak pada arah jam 3, 6, dan 9 dari fantom. Nilai akurasi tertinggi didapatkan pada mode Xper CT Cerebral HD pada posisi pengukuran pusat dengan nilai presentase perbandingan sebesar 0,9%, sementara nilai akurasi terendah didapatkan pada mode Xper CT Cerebral LD pada posisi pengukuran arah jam 6 dengan nilai prensentase perbandingan sebesar 647,3%.......Cone Beam Computed Tomography (CBCT) in 3D rotational angiography (3DRA) uses cone-shaped X-ray beams with non-360 degrees rotation. However, current dosimetry calculation methods for 3DRA, which are based on CTDI formalism, may not be suitable due to the larger cone beam angles compared to fan beam angles and the rotation of 3DRA being not a full 360-degree rotation. This study aims to analyze the dose distributions in simulations and direct measurements in 3DRA scans. The method involves comparing the simulation results of dose distributions using EGSnrc software with direct measurements Philips Allura FD20 angiography (in three preset modes) using a head CTDI phantom and an ionization chamber. To analyze the dose distributions in 3DRA, five virtual CTDI phantoms are generated to represent holes corresponding to the placement of dosimeters at different positions (at center, 3, 6, 9, and 12 o'clock). The voxel size of the phantoms is adjusted to 1×1×1 mm². The modeling and simulation of the X-ray tube in the 3DRA system using the BEAMnrc software. The DOSXYZnrc software is used to simulate the irradiation on the virtual phantom. The simulation is performed with 2.5×108 histories, and the energy cutoff value is set at 0.512 MeV for electron transport and 0.001 MeV for photon transport. The results show that the areas most exposed to radiation in all three preset modes of 3DRA are located on the sides and bottom (at 3, 6, and 9 o'clock) of the phantom. The highest accuracy value was obtained in the Xper CT Cerebral HD mode at the center position with a percentage comparison value of 0.9%, while the lowest accuracy value was obtained in the Xper CT Cerebral LD mode at the 6 o'clock position with a percentage comparison value of 647.3%."