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Abstrak :
buku ini membahas tentang bahaya tumor otak dan peranan pencitraan dalam otak.

Abstrak :
[ABSTRAK
Tumor otak (TO) merupakan penyebab kematian kedua dari semua kanker yang terjadi pada anak. TO memiliki gambaran klinis, radiologis dan histopatologis yang sangat bervariasi karena proses pengembangan sel-sel jaringan otak masih berlanjut sampai usia 3 tahun. Data penelitian mengenai TO pada anak masih sedikit. Tujuan: Untuk mengetahui gambaran klinis, radiologis, histopatologis dan faktor prognostik TO di Departemen Ilmu Kesehatan Anak FKUI/ RS. Dr. Ciptomangunkusumo Jakarta periode tahun 2010 - 2015. Metode Penelitian: Kohort retrospektif dilakukan pada semua anak dengan TO primer yang berobat/dirawat di Departemen Ilmu Kesehahatan Anak FKUI/RS Dr. Ciptomangunkusumo Jakarta. Hasil: Didapatkan 88 pasien TO primer, terdiri dari 16 pasien berusia kurang dari 3 tahun dan 72 pasien berusia lebih dari 3 tahun, laki-laki 53% dan perempuan 47%. Anak usia kurang dari 3 tahun mengalami gejala sakit kepala (63%) dan kejang (56%), berdasarkan radiologis letak TO yang terbanyak adalah di cerebral ventrikel (25%) dan cerebellum (24%), berdasarkan histopatologis jenis TO yang terbanyak adalah Astrositoma (31%) dan Medulloblastoma (25%). Anak usia lebih dari 3 tahun mengalami gejala sakit kepala (81%) dan gangguan penglihatan (65%), berdasarkan radiologis letak TO yang terbanyak adalah di cerebellum (24%) dan suprasellar (10 %), berdasarkan histopatologis jenis TO yang terbanyak adalah Medulloblastoma (21%), Astrositoma (18%) dan Glioma (17%). Angka kehidupan TO adalah 37 %. Tidak didapatkan faktor prognostik TO yang bermakna. Kesimpulan: Gejala TO tersering adalah sakit kepala, berdasarkan radiologis letak tumor terbanyak adalah di cerebellum serta berdasarkan histopatologis jenis tumor terbanyak adalah Medulloblastoma dan Astrositoma. Tidak didapatkan faktor prognostik TO pada anak.

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ABSTRACT
Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor., Background: Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor.]

Abstrak :
Berdasarkan Global Cancer Observatory (GLOBOCAN), tumor otak diestimasikan berada di urutan ke-19 sebagai tumor yang paling umum terjadi dan ke-12 sebagai penyebab utama kematian akibat kanker di dunia pada tahun 2020. Walaupun begitu, informasi terkait epidemiologi tumor otak di Indonesia masih sangat terbatas. Belum diwajibkannya pendataan kasus tumor di Indonesia merupakan salah satu alasannya. Tumor otak dapat dideteksi menggunakan pencitraan medis, seperti computed tomography (CT) scan dan magnetic resonance imaging (MRI). Deteksi dini tumor otak merupakan hal yang penting karena dapat meningkatkan tingkat keberlangsungan hidup dari pasien. Saat ini, banyak perkembangan teknologi yang dapat dimanfaatkan untuk membantu kehidupan manusia, salah satunya adalah deep learning (DL). Akan tetapi, data medis merupakan data yang sensitif, sehingga menjadi salah satu tantangan dalam penerapan DL di bidang kesehatan. Untuk mengatasi privasi dan keterbatasan data, terdapat metode federated learning (FL) yang memungkinkan untuk dilakukannya pelatihan data lokal pada klien tanpa menyebarkan data klien tersebut. Pada penelitian ini, akan dibentuk simulasi klasifikasi tumor otak menggunakan DL berbasis FL. Tujuan utama dari penelitian ini adalah untuk menganalisis performa model yang dihasilkan dari federated learning dan membandingkannya dengan metode training konvensional. Terdapat empat cycle data dengan tiga cycle berasal dari dataset pertama (M. Nickparvar) dan satu cycle dari dataset kedua (J. Cheng). Hasil akurasi dan F1-score tertinggi dari simulasi federated didapatkan pada epoch (jumlah putaran pelatihan data pada tiap klien) 15 dan round (jumlah putaran mulai dari tahap pembagian parameter model global kepada klien sampai dengan agregasi model) 15, yaitu 0.8375 dan 0.8384 (cycle 1), 0.7625 dan 0.7567 (cycle 2), 0.8375 dan 0.8308 (cycle 3), serta 0.7333 dan 0.7255 (dataset 2). Hasil akurasi dan F1-score tertinggi dari simulasi standard pelatihan lokal pada tiap cycle adalah 0.75 dan 0.7568 (cycle 1), 0.6875 dan 0.6677 (cycle 2), 0.675 dan 0.6744 (cycle 3), serta 0.7222 dan 0.7085 (dataset 2). Hasil akurasi dan F1-score tertinggi dari simulasi standard pelatihan all data pada tiap cycle adalah 0.7625 dan 0.7644 (cycle 1), 0.6875 dan 0.6723 (cycle 2), 0.775 dan 0.7766 (cycle 3), serta 0.6 dan 0.5355 (dataset 2). Berdasarkan pengujian hasil simulasi, korelasi epoch dan round terhadap performa model signifikan pada dataset kedua (Pacc-epoch = 0.019; PF1-epoch = 0.006; Pacc-round = 0.008; PF1-round = 0.025), tetapi hanya korelasi round yang signifikan pada dataset pertama (cycle 1 Pacc-round < 0.001 dan PF1-round < 0.001; cycle 2 Pacc-round = 0.004 dan PF1-round = 0.003; cycle 3 Pacc-round < 0.001 dan PF1-round < 0.001). Selain itu, performa model global hasil federated learning lebih baik daripada performa model lokal dan model pelatihan standard. Tidak ditemukan perbedaan signifikan antara performa model dataset pertama dengan cycle yang berbeda (Pacc between cycles = 0.679; PF1 between cycles = 0.770) serta tidak ditemukan juga perbedaan signifikan antara performa model dataset pertama dan kedua (Pacc cycle 1-dataset 2 = 0.103; Pacc cycle 2-dataset 2 = 0.334; Pacc cycle 3-dataset 2 = 0.103; PF1 cycle 1-dataset 2 = 0.140; PF1 cycle 2-dataset 2 = 0.120; Pacc cycle 3-dataset 2 = 0.140). ......Based on the Global Cancer Observatory (GLOBOCAN), brain tumors are estimated to rank 19th among the most common tumors and 12th as the leading cause of cancer-related deaths worldwide in 2020. However, information regarding the epidemiology of brain tumors in Indonesia remains very limited. One reason is that case registration for tumors is not yet mandatory in Indonesia. Brain tumors can be detected using medical imaging, such as computed tomography (CT) scan and magnetic resonance imaging (MRI). Early detection of brain tumors is crucial as it can improve the survival rates of patients. Currently, many technological advancements can be utilized to aid human life, one of which is deep learning (DL). However, medical data is sensitive, presenting a challenge in applying DL in healthcare. To address privacy and data limitation problems, there is a method called federated learning (FL) that enables local data training on clients without sharing the clients' data. This study aims to simulate brain tumor classification using DL based on FL. The main objective of this research is to analyze the performance of the model generated from federated learning and compare it with conventional training methods. There are four data cycles, with three cycles from the first dataset (M. Nickparvar) and one cycle from the second dataset (J. Cheng). The highest accuracy and F1-score from the federated simulation were achieved at epoch (number of training rounds on each client) 15 and round (number of rounds starting from the global model parameter distribution to the clients until model aggregation) 15, which are 0.8375 and 0.8384 (cycle 1), 0.7625 and 0.7567 (cycle 2), 0.8375 and 0.8308 (cycle 3), and 0.7333 and 0.7255 (dataset 2). The highest accuracy and F1-score from the standard local training simulation in each cycle are 0.75 and 0.7568 (cycle 1), 0.6875 and 0.6677 (cycle 2), 0.675 and 0.6744 (cycle 3), and 0.7222 and 0.7085 (dataset 2). The highest accuracy and F1-score from the standard all data training simulation in each cycle are 0.7625 and 0.7644 (cycle 1), 0.6875 and 0.6723 (cycle 2), 0.775 and 0.7766 (cycle 3), and 0.6 and 0.5355 (dataset 2). Based on the simulation, the correlation between epoch and round on model performance is significant in the second dataset (Pacc-epoch = 0.019; PF1-epoch = 0.006; Pacc-round = 0.008; PF1-round = 0.025), but only the round correlation is significant in the first dataset (cycle 1 Pacc-round < 0.001 and PF1-round < 0.001; cycle 2 Pacc-round = 0.004 and PF1-round = 0.003; cycle 3 Pacc-round < 0.001 and PF1-round < 0.001). Moreover, the performance of the global model resulting from federated learning is better than the local model performance and standard all data training model performance. No significant difference was found between the performance of the first dataset with different cycles (Pacc between cycles = 0.679; PF1 between cycles = 0.770) nor between the performance of the first and second datasets (Pacc cycle 1-dataset 2 = 0.103; Pacc cycle 2-dataset 2 = 0.334; Pacc cycle 3-dataset 2 = 0.103; PF1 cycle 1-dataset 2 = 0.140; PF1 cycle 2-dataset 2 = 0.120; Pacc cycle 3-dataset 2 = 0.140).

Abstrak :
ABSTRAK
Latar belakang: Gangguan fungsi kognitif merupakan salah satu defisit neurologis kedua tersering setelah sakit kepala pada tumor intrakranial. Gangguan fungsi kognitif yang paling sering terjadi pada tumor otak adalah gangguan fungsi eksekutif. Penilaian fungsi kognitif sebelum dilakukan operasi maupun radioterapi penting sebagai data dasar klinis pasien. Tujuan: Mendapatkan informasi mengenai penilaian fungsi kognitif sebelum dilakukan operasi maupun radioterapi sebagai data dasar klinis pasien. Metode: Disain penelitian ialah survei potong lintang dengan pengambilan sampel secara konsekutif. Data diperoleh dari Divisi Fungsi Luhur Poliklinik saraf dan Departemen Rekam Medis RSUPN Cipto Mangunkusumo periode Januari 2009-Maret 2016. Subjek penelitian berusia 18-65 tahun dan telah terdiagnosis tumor otak, memiliki hasil histopatologi, serta telah menjalani pemeriksaan fungsi luhur preoperatif. Hasil: Terdapat 77 subjek penelitian dengan proporsi subjek laki-laki (50,6%) dan perempuan (49,4%) hampir sama, terbanyak berusia 40 tahun ke atas (67,5%), serta berpendidikan terutama 12 tahun ke atas (61%). Glioma (46,7%) dan meningioma (63,2%) merupakan dua tumor otak primer terbanyak, sedangkan paru (34,4%) dan payudara (18,8%) adalah asal metastasis otak terbanyak. Hampir semua subjek mengalami gangguan fungsi kognitif (96,1%), terutama ranah jamak (93,2%). Ranah memori dan fungsi eksekutif merupakan dua ranah yang paling sering terganggu. Proporsinya semua metastasis dan 80% tumor otak primer mengalami gangguan memori. Sebesar 77,5% tumor primer dan 89,7% metastasis otak mengalami gangguan fungsi eksekutif. Kesimpulan: Hampir semua fungsi kognitif pada tumor otak primer dan metastasis terganggu, tetapi gangguan pada metastasis otak lebih berat. Ranah jamak merupakan ranah yang paling banyak terganggu, terutama memori dan fungsi eksekutif.

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ABSTRACT
Aim: To obtain information about cognitive assessment before surgery and radiotherapy. Methods: This study was a cross-sectional retrospective study using consecutive sampling. Data obtained from neurobehavior division of Neurology Clinic and Medical Record Department of Cipto Mangunkusumo Hospital started at January 2009 to April 2016. Subjects, aged 18 to 65 years old, diagnosed brain tumors, had histopatologic data, and done cognitive exam before surgery. Results: There were 77 subjects, with no notable difference in gender proportion (50,6% male subjects and 49,4% female subjects). All were aged 40 years old above (67,5%) and had education level not lower than 12 years (61%). Glioma (46,7%) and meningioma (63,2%) are two most common primary brain tumors, whilst lungs (34,4%) and breast (18,8%) are two most major brain metastasis origin. Most subjects had cognitive impairments (96,1%), predominantly multidomain (93,2%). Of all domain, memory and executive function are mostly affected. All metastasis, and 80% primary brain tumor had memory impairment and 77,5% primary brain tumor and 89,7% brain metastasis had executive impairment. Conclusion: Almost all cognitive domain impaired in brain tumors, particularly in brain metastasis. It suggested that multiple cognitive domain impairment were majorly impaired, with memory and executive function as the most common domain.

Abstrak :
[Latar Belakang Gangguan penglihatan adalah gejala kedua yang sering muncul pada tumor otak setelah nyeri kepala. Gejala gangguan penglihatan yang paling sering terjadi pada tumor otak adalah penurunan visus atau tajam penglihatan (low vision sampai kebutaan), sedang tanda yang paling sering dijumpai adalah atrofi n. optikus dan papilledema. Penurunan tajam penglihatan yang dialami penderita tumor otak dapat sangat berat hingga berupa kebutaan. Sampai saat ini belum terdapat data angka kejadian gangguan penglihatan sampai kebutaan pada tumor otak di Indonesia. Metode Sebagai studi potong lintang analitik, dikumpulkanlah data pasien penderita tumor otak di atas usia 6 tahun yang datang berobat ke poliklinik Bedah Saraf FKUIRSCM pasien September 2013 hingga Februari 2014 dari catatan rekam medis. Hasil Jumlah pasien tumor otak yang mengalami buta sebanyak 37 orang (34,6 %) dengan usia rata-rata 45,3 (SD 11,3 tahun). Sebesar 86,5 % penderita berada pada usia produktif 15-54 tahun. Dari 37 pasien tumor otak yang buta terlihat proporsi gejala penyerta terbesar adalah sefalgia (terutama sefalgia kronis), diikuti oleh gangguan oftalmologi lain. Data pemeriksaan funduskopi hanya ditemukan pada kurang dari 50 % penderita, dengan temuan yang terbanyak adalah papil atrofi. Kesimpulan Besar angka kebutaan pada pasien tumor otak menunjukkan bahwa kondisi ini tidak hanya menjadi masalah medis saja tetapi juga masalah sosial yang serius. Banyaknya jumlah pasien tanpa data funduskopi menandakan masih lemahnya standar pemeriksaan neurooftalmologi ataupun pencatatan yang ada saat ini, padahal pemeriksaan funduskopi berperan sangat penting mendeteksi dini kejadian tumor otak pada pasien dengan gangguan penglihatan. ......Background Vision impairment is the second most common symptom in brain tumor after headache, with decreased visual acuity or low vision as its most common manifestation, and optic nerve atrophy and papilledema as its most common sign. Blindness may be the final outcome of this impairment. Until now, there is no data regarding the prevalence of vision impairment in brain tumor patient in Indonesia. Method As a analytic cross-sectional study, data is collected from the medical record regarding brain tumor patient above the age of 6 years old who were seen in the neurosurgery facility in FKUI-RSCM from September 2013 to February 2014. Result As much as 37 patient (34,6%) brain tumor patient were found to be blind; mean age was 45,3 years old (SD 11,3 years old), with 86,5% patient was in the productive age 15-54 years old. The commonest related symptoms was headache (especially chronic headache), followed by other ophthalmologic symptoms. Funduscopy data was found only in less than 50% patient; the commonest finding was optic nerve atrophy. Conclusion Blindness rate in brain tumor patient is not just a medical issue, but also a social one. Funduscopy usage must be encouraged more to provide early detection for brain tumor patient with vision impairment.;Background Vision impairment is the second most common symptom in brain tumor after headache, with decreased visual acuity or low vision as its most common manifestation, and optic nerve atrophy and papilledema as its most common sign. Blindness may be the final outcome of this impairment. Until now, there is no data regarding the prevalence of vision impairment in brain tumor patient in Indonesia. Method As a analytic cross-sectional study, data is collected from the medical record regarding brain tumor patient above the age of 6 years old who were seen in the neurosurgery facility in FKUI-RSCM from September 2013 to February 2014. Result As much as 37 patient (34,6%) brain tumor patient were found to be blind; mean age was 45,3 years old (SD 11,3 years old), with 86,5% patient was in the productive age 15-54 years old. The commonest related symptoms was headache (especially chronic headache), followed by other ophthalmologic symptoms. Funduscopy data was found only in less than 50% patient; the commonest finding was optic nerve atrophy. Conclusion Blindness rate in brain tumor patient is not just a medical issue, but also a social one. Funduscopy usage must be encouraged more to provide early detection for brain tumor patient with vision impairment., Background Vision impairment is the second most common symptom in brain tumor after headache, with decreased visual acuity or low vision as its most common manifestation, and optic nerve atrophy and papilledema as its most common sign. Blindness may be the final outcome of this impairment. Until now, there is no data regarding the prevalence of vision impairment in brain tumor patient in Indonesia. Method As a analytic cross-sectional study, data is collected from the medical record regarding brain tumor patient above the age of 6 years old who were seen in the neurosurgery facility in FKUI-RSCM from September 2013 to February 2014. Result As much as 37 patient (34,6%) brain tumor patient were found to be blind; mean age was 45,3 years old (SD 11,3 years old), with 86,5% patient was in the productive age 15-54 years old. The commonest related symptoms was headache (especially chronic headache), followed by other ophthalmologic symptoms. Funduscopy data was found only in less than 50% patient; the commonest finding was optic nerve atrophy. Conclusion Blindness rate in brain tumor patient is not just a medical issue, but also a social one. Funduscopy usage must be encouraged more to provide early detection for brain tumor patient with vision impairment.]

Abstrak :
Tujuan: Mengetahui kualitas hidup pasien anak dengan tumor otak yang telah menjalani radioterapi di Rumah Sakit Umum Pusat Nasional (RSUPN) Dr. Cipto Mangunkusumo berdasarkan PedsQL™ 4.0 skala generik serta mengetahui kesintasannya serta faktor risiko yang berpengaruh terhadap mortalitas. Metode: Dilakukan studi dengan desain potong lintang yang melibatkan 88 pasien dan sebanyak 26 diantaranya turut serta dalam penilaian kualitas hidup dengan menggunakan instrumen Pediatric Quality of Life Infentory (PedsQL™) 4.0 skala generik. Hasil: Dari 88 pasien yang terlibat dalam penelitian ini, sebanyak 31 pasien loss to follow up, 28 pasien terkonfirmasi meninggal, dan 29 pasien terkonfirmasi hidup. Kesintasan (OS) 1 tahun, 3 tahun, dan 5 tahun beturut-turut sebesar 71,6 %, 43,2%, dan 5,7%. Lokasi tumor infratentorial dan usia yang lebih muda pada saat diagnosis merupakan faktor risiko yang dapat meningkatkan mortalitas pada pasien anak dengan tumor otak pasca radioterapi dengan nilai p 0,044 dan 0,036. Nilai rerata kualitas berdasarkan laporan anak dan laporan orang tua PedsQL™ 4.0 skala generik adalah sebesar 70,686 dan 70,152. Penghasilan keluarga ≥ Rp 4.200.000,00 merupakan faktor yang meningkatkan kualitas hidup anak dengan tumor otak pasca radioterapi (p=0,008). Kesimpulan: Kualitas hidup pada pasien anak dengan tumor otak pasca radioterapi dapat dipengaruhi oleh faktor sosioekonomi yaitu penghasilan keluarga. Lokasi tumor dan usia yang lebih muda saat didiagnosis dapat meningkatkan risiko mortalitas. ......Aims: This study was aimed to show the quality of life in children with brain tumor after radiotherapy in Dr. Cipto Mangunkusumo National General Hospital based on PedsQL™ 4.0 generic core scale. This study was also aimed to show the overall survival and mortality risk factors. Methods: This cross-sectional study consisted of 88 children with brain tumor after radiotherapy. There were 26 of 88 children assessed by PedsQL™ 4.0 generic core scale. Results: Of the 88 patients involved in this study, 31 patients lost to follow-up, 28 patients were confirmed dead, and 29 patients were confirmed alive. One year, 3 years, and 5 years overall survival were respectively 71.6%, 43.2%, and 5.7%. Infratentorial tumor location and younger age at diagnosis were risk factors that can increase the incidence of mortality (p= 0.044 and 0.036). Children’s quality of life were 70.686 and 70.152 based on PedsQL ™ children and parents' reports. Family income ≥ IDR 4,200,000.00 was a factor that improved the quality of life in children with brain tumors after radiotherapy (p = 0.008). Conclusion: Quality of life in pediatric patients with brain tumor after radiotherapy could be influenced by family income. The location of the tumor and the younger age at diagnosis could increase the risk of mortality.

Abstrak :
ABSTRAK
Peningkatan kualitas citra medis khususnya untuk bagian kepala manusia terus dikembangkan, termasuk dengan pemodelan 3D. Hal ini dilakukan untuk mengurangi kesalahan dalam proses diagnosa dan memfasilitasi pendeteksian tumor otak dengan pendekatan 3D. Dalam prosesnya, citra MRI otak dianalisa secara 3D sehingga diperoleh bagian tumor otak. Citra MRI dikonversi dari citra berformat MINC. Citra diklasifikasi untuk mendeteksi objek menggunakan K-Means Clustering yang akan memisahkan bagian tumor dan otak. Proses filter dilakukan menggunakan Non-Local Means sehingga noise hasil pengolahan dapat berkurang dari proses sebelumnya. Hasil citra pengolahan disegmentasi untuk meningkatkan dan mendukung proses rekonstruksi menggunakan Thresholding. Terakhir adalah merekonstruksi citra dalam bentuk 3D menggunakan metode Marching Cube. Evaluasi akurasi sistem meliputi pengurangan resolusi, pengujian citra normal, uji perbandingan, penggantian format citra dan penambahan noise. Hasil akurasi pendeteksian tumor otak mencapai 100% untuk format PNG dan resolusi 512x512, 97,7% untuk resolusi 256x256, 96,9% untuk citra normal tanpa tumor dan 97,96% berdasarkan perbandingan data olah dengan data referensi. Format PNG memiliki akurasi dibandingkan format JPEG dengan perbedaan sebesar 4%. Pengujian dengan menambahkan noise menghasilkan akurasi 87,6% untuk densitas 0,01, 83,6% untuk 0,05 dan 74,5% untuk 0,09.

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ABSTRACT
Medical image enhancement especially for human brain imageries is rapidly developed, including 3D modeling. This research is aimed to reduce the error of diagnosis process and facilitate brain tumor detection using 3D approach. In the process, 3D brain from MRI imageries is analyzed to detect brain tumors. MRI image is converted from MINC format. Then, the image is classified to detect objects using K-Means Clustering to divide each part of brain. Filtering is performed using Non-Local Means to remove noise from previous processes. The result of imageries are segmented to enhance and support reconstruction process using Thresholding. Finally, 3D image reconstruction is performed using Marching Cube method. The accuracy of brain tumor detection is evaluated of resolution reduction, non tumor image testing, comparison testing, modifying image format, and adding noise. The accuracy rate of brain tumor detection is 100% for PNG format and 512x512 resolution, 97,7% for 256x256 resolution, 96,9% for non tumor image and 97,96% for comparison between ideal image and reference data. PNG format has better accuracy with JPEG by 4% improvement. The accuracy of adding noise is 87,6% for 0,01 density, 83,6% for 0,05 and 74,5% for 0,09.