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"[ABSTRAKPendahuluan : Glioma adalah jenis tumor yang paling umum dari neoplasma intraserebralprimer. Tumor ganas primer sistem saraf pusat (SSP) mencapai sekitar 2% dari semua kankerdan high grade glioma adalah jenis yang paling banyak ditemukan. High grade gliomamenyebabkan tingkat morbiditas dan mortalitas yang tinggi. Saat ini belum ada data yangmenggambarkan profil pasien glioma yang menjalani radioterapi di Indonesia.Metode penelitian : Penelitian ini merupakan penelitian retrospektif deskriptif analitikterhadap 121 pasien glioma yang mendapat radiasi di departemen Radioterapi RSUPN Dr.Cipto mangunkusumo dari Januari 2009 sampai Januari 2014. Data diperoleh dari catatanmedisdan hasil penelusuran melalui telepon terhadap pasien atau keluarganya. Respon tumordianalisa terhadap 22 pasien yang mempunyai CT scan atau MRI pre dan post radiasi denganmenggunakan kriteria RECIST.Hasil : Sebagian besar pasien adalah laki-laki (53,7%), dengan usia rata-rata 45 tahun.Histopatologi yang paling banyak ditemukan adalah astrositoma. Prosedur bedah yang palingbanyak ditemukan pada penelitian ini adalah craniotomi removal tumor (70%). Teknik 3DCRT paling banyak digunakan yaitu pada 77,7% pasien. Nimotuzumab sebagai antibodimonoklonal digunakan pada 9% pasien. Respon parsial ditemukan 59,1%. Analisis kesintasanhidup tiga tahun dari seratus sebelas pasien yang memenuhi kriteria didapatkan angkakesintasan yaitu 46,15%. Analisis kaplan meyer menunjukkan overall treatment timemerupakan faktor prognostik untuk kesintasan hidup (p = 0,016).Kesimpulan : Teknik operasi terbanyak pada pasien glioma yang menjalani radiasi didepartemen radioterapi RSUPN DR. Cipto Mangunkusumo adalah kraniotomi removal tumor(70,9%). Teknik 3D CRT adalah teknik radiasi yang paling banyak digunakan. Responparsial ditemukan 59,1%. Kesintasan hidup tiga tahun pasien glioma yaitu 46,2% dan overalltreatment time merupakan faktor prognostik yang bermakna untuk kesintasan hidup

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ABSTRACTIntroduction : Glioma is the most common type of primary intracerebral neoplasms. Highgrade glioma being the most frekuent type found (70,9%) causes a high morbidity andmortality rate. There is currently no data describing the profile management of patientsundergoing radiotherapy glioma in Indonesia.Methods : This study Retrospective analytic descriptive study of 121 glioma patients fromjanuari 2009 until december 2014. The data was obtained from medical records and indivualcontact via telephone. Tumor response was evaluated in 22 patients with pre and postirradiation imaging (CT or MRI) using 3D volumetric data and assessed via RECISTcriteria.Results : Most of our patients were male (53,7%), with median age 45 years old.Astrocytoma was the most histopathological type found. 70.9% of Patients who receivedradiotherapy in Cipto Mangunkusumo hospital were post craniotomi tumor removal. 3DConformal technique was used in 81.0% of patients. Seventy nine point three had a two graydose perfraction. Provision of chemotherapy in patients undergoing radiation still only at7.4% of patients. Nimotuzumab as a monoclonal antibody used on 9% patient. The medianoverall treatment time was 45 days and delay treatment time 38 days. Fifty nine point onepercent of partial respon was found. Local recurrences were found throughout the follow-upof 6.6%. Analysis kaplan meyer showed that overall treatment time was a prognostic factorfor overal survival rate (p=0,016).Conclusions : : Almost seventy one percent of glioma patients who received radiotherapyhad craniotomy removal tumor. 3D Conformal techniques is the most widely used. Fifty ninepoint one percent of partial respon founded. Three years overall survival was 46,2% andoverall treatment time was found as a factor that significantly affects overall survivalprognosis.;Introduction : Glioma is the most common type of primary intracerebral neoplasms. Highgrade glioma being the most frekuent type found (70,9%) causes a high morbidity andmortality rate. There is currently no data describing the profile management of patientsundergoing radiotherapy glioma in Indonesia.Methods : This study Retrospective analytic descriptive study of 121 glioma patients fromjanuari 2009 until december 2014. The data was obtained from medical records and indivualcontact via telephone. Tumor response was evaluated in 22 patients with pre and postirradiation imaging (CT or MRI) using 3D volumetric data and assessed via RECISTcriteria.Results : Most of our patients were male (53,7%), with median age 45 years old.Astrocytoma was the most histopathological type found. 70.9% of Patients who receivedradiotherapy in Cipto Mangunkusumo hospital were post craniotomi tumor removal. 3DConformal technique was used in 81.0% of patients. Seventy nine point three had a two graydose perfraction. Provision of chemotherapy in patients undergoing radiation still only at7.4% of patients. Nimotuzumab as a monoclonal antibody used on 9% patient. The medianoverall treatment time was 45 days and delay treatment time 38 days. Fifty nine point onepercent of partial respon was found. Local recurrences were found throughout the follow-upof 6.6%. Analysis kaplan meyer showed that overall treatment time was a prognostic factorfor overal survival rate (p=0,016).Conclusions : : Almost seventy one percent of glioma patients who received radiotherapyhad craniotomy removal tumor. 3D Conformal techniques is the most widely used. Fifty ninepoint one percent of partial respon founded. Three years overall survival was 46,2% andoverall treatment time was found as a factor that significantly affects overall survivalprognosis.;Introduction : Glioma is the most common type of primary intracerebral neoplasms. Highgrade glioma being the most frekuent type found (70,9%) causes a high morbidity andmortality rate. There is currently no data describing the profile management of patientsundergoing radiotherapy glioma in Indonesia.Methods : This study Retrospective analytic descriptive study of 121 glioma patients fromjanuari 2009 until december 2014. The data was obtained from medical records and indivualcontact via telephone. Tumor response was evaluated in 22 patients with pre and postirradiation imaging (CT or MRI) using 3D volumetric data and assessed via RECISTcriteria.Results : Most of our patients were male (53,7%), with median age 45 years old.Astrocytoma was the most histopathological type found. 70.9% of Patients who receivedradiotherapy in Cipto Mangunkusumo hospital were post craniotomi tumor removal. 3DConformal technique was used in 81.0% of patients. Seventy nine point three had a two graydose perfraction. Provision of chemotherapy in patients undergoing radiation still only at7.4% of patients. Nimotuzumab as a monoclonal antibody used on 9% patient. The medianoverall treatment time was 45 days and delay treatment time 38 days. Fifty nine point onepercent of partial respon was found. Local recurrences were found throughout the follow-upof 6.6%. Analysis kaplan meyer showed that overall treatment time was a prognostic factorfor overal survival rate (p=0,016).Conclusions : : Almost seventy one percent of glioma patients who received radiotherapyhad craniotomy removal tumor. 3D Conformal techniques is the most widely used. Fifty ninepoint one percent of partial respon founded. Three years overall survival was 46,2% andoverall treatment time was found as a factor that significantly affects overall survivalprognosis., Introduction : Glioma is the most common type of primary intracerebral neoplasms. Highgrade glioma being the most frekuent type found (70,9%) causes a high morbidity andmortality rate. There is currently no data describing the profile management of patientsundergoing radiotherapy glioma in Indonesia.Methods : This study Retrospective analytic descriptive study of 121 glioma patients fromjanuari 2009 until december 2014. The data was obtained from medical records and indivualcontact via telephone. Tumor response was evaluated in 22 patients with pre and postirradiation imaging (CT or MRI) using 3D volumetric data and assessed via RECISTcriteria.Results : Most of our patients were male (53,7%), with median age 45 years old.Astrocytoma was the most histopathological type found. 70.9% of Patients who receivedradiotherapy in Cipto Mangunkusumo hospital were post craniotomi tumor removal. 3DConformal technique was used in 81.0% of patients. Seventy nine point three had a two graydose perfraction. Provision of chemotherapy in patients undergoing radiation still only at7.4% of patients. Nimotuzumab as a monoclonal antibody used on 9% patient. The medianoverall treatment time was 45 days and delay treatment time 38 days. Fifty nine point onepercent of partial respon was found. Local recurrences were found throughout the follow-upof 6.6%. Analysis kaplan meyer showed that overall treatment time was a prognostic factorfor overal survival rate (p=0,016).Conclusions : : Almost seventy one percent of glioma patients who received radiotherapyhad craniotomy removal tumor. 3D Conformal techniques is the most widely used. Fifty ninepoint one percent of partial respon founded. Three years overall survival was 46,2% andoverall treatment time was found as a factor that significantly affects overall survivalprognosis.]"

"Latar Belakang : Adiponektin saat ini dianggap berperan penting dalam etiopatogenesis gangguan metabolik dan inflamasi termasuk artritis reumatoid (AR). Data terbaru menekankan peran adiponektin dalam peradangan dan degradasi matriks yang dapat menyebabkan kerusakan sendi erosif. Hubungan tingkat adiponektin serum dengan kerusakan sendi radiografi pada pasien dengan AR perlu diteliti lebih lanjut. Selain itu, telah dilaporkan bahwa adiponektin memberikan efek anti-aterosklerosis pada pasien non AR. Menariknya, beberapa studi telah melaporkan peningkatan kadar adiponektin pada pasien AR, hal ini berlawanan mengingat tingginya prevalensi aterosklerosis pada AR. Dengan demikian, efek adiponektin pada aterosklerosis belum sepenuhnya jelas. Metode: Penelitian ini merupakan studi potong lintang. Subjek penelitian diambil dari 50 orang pasien yang memenuhi kriteria EULAR/ACR 2010 untuk AR yang datang ke poliklinik reumatologi RSCM Jakarta. Pengambilan sampel adalah secara consecutive sampling. Dilakukan pemeriksaan kadar adiponektin serum dan foto rontgen tangan/kaki dengan menggunakan Skor Sharp-van der Heijde (SSH). Adanya aterosklerosis ditentukan dengan mengukur ketebalan Tunika Intima Media arteri karotis melalui pemeriksaan USG karotis bilateral. Hasil: Dari 50 pasien yang diteliti, 28 (56%) mengalami peningkatan kadar adiponektin. Aterosklerosis ditemukan pada 13 (26%) subjek. Uji Spearman memperlihatkan tidak ada hubungan antara adiponektin serum dengan aterosklerosis pada pasien AR (p =0.706 dan r=0,055). Adiponektin juga tidak berhubungan dengan skor SSH, tetapi setelah di analisa dengan beberapa karakteristik AR, adiponektin berhubungan dengan SSH pada kelompok pasien dengan anti CCP negatif (p=0,036 dan r=0,38). Kesimpulan: Dari penelitian ini, peneliti menyimpulkan bahwa kadar adiponektin serum meningkat pada pasien AR, tetapi peningkatan adiponektin serum tidak berhubungan dengan aterosklerosis. Adiponektin berhubungan dengan kerusakan sendi pada kelompok pasien dengan anti CCP negatif.

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Background : Adiponectin is now considered important players in the etiopathogenesis of metabolic and inflammatory disorder including rheumatoid arthritis ( RA ). Recent data stress the role of adiponectin in inflammation and matrix degradation that may contribute to erosive joint damage. The association of serum adiponectin level with radiographic joint damage in patients with RA need to be explored. Furthermore, it has been reported that adiponectin exerts an antiatherosclerotic effect in non RA patients. Interestingly, several studies have reported increased level of adiponectin in RA patients, findings which appear paradoxical in light of the higher prevalence of atherosclerosis in RA. Thus, the effect of adiponectin on atherosclerosis has not been clarified sufficiently.

Methods: This was a cross sectional study. Subjects were fifty patients who fulfill Eular Criteria/ACR 2010 for RA from the Rheumatology clinic of Cipto Mangunkusumo Hospital / Faculty of Medicine University of Indonesia Jakarta. Patients with RA underwent serum adiponectin assessment and hand/feet x-rays, scored using the Sharp-van der Heijde Score (SHS). Carotid intima media thickness represent of atherosclerosis was measured by using Ultrasound (USG Bmode).

Results: Of the 50 patients studied, 28 (56%) showed an increased in adiponectin levels. Atherosclerosis was diagnosed in 13 (26%) of this subject. Spearman test showed there was no correlation between adiponectin serum level with adiponectin in RA patients (p =0.706 and r=0,055). Adiponectin level did not correlate with SHS, but after adjusting for disease characteristics, adiponectin level correlate with SHS in negative anti CCP group (p=0,036 and r=0,38).

Conclusion : From this study, we conclude that adiponectin serum level was increase in rheumatoid arthritis patients, but the increasing of the adiponectin serum level was not correlated with atherosclerosis event. Adiponectin level correlate with radiographic joint destruction in negative anti CCP group."

"Mortalitas penderita artritis reumatoid(AR) yang cukup tinggi disebabkan oleh penyakit kardiovaskular akibat aterosklerosis.Penelitian ini bertujuan untuk mengetahui sensitivitas dan spesifitas skor kalsifikasi arkus aorta di foto polos toraks berdasarkan klasifikasi Ogawa dalam mendeteksi aterosklerosis pada penderita AR. Penelitian ini menggunakan desain potong lintang pada 76 pasien AR di Poliklinik Reumatologi RSUPN Cipto Mangunkusumo. Hasil penelitian menunjukkan sensitivitas 25% dan spesifitas 91,7% pada titik potong skor Ogawa 3,125%, dengan demikian lebih baik untuk mendeteksi pasien AR tanpa aterosklerosis. Pasien AR dengan kalsifikasi arkus aorta kemungkinan memiliki aterosklerosis sebesar 3,7 kali daripada pasien AR tanpa kalsifikasi arkus aorta.

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Mortality of rheumatoid arthritis (RA) patients which is quite high caused by cardiovascular disease due to atherosclerosis. This study aims to determine the sensitivity and specificity of the aortic arch calcification score on plain chest X-ray based on classification Ogawa in detecting atherosclerosis in RA patients. This study used a cross-sectional design in 76 patients at the Rheumatology Division Cipto Mangunkusumo Hospital. The results showed a sensitivity of 25% and specificity of 91.7% at the cut off point Ogawa scores 3.125%, thus it is better to detect RA patients without atherosclerosis. The possibility of arthritis rheumatoid patients with aortic arch calcification having atherosclerosis by 3.7 times than RA patients without aortic arch calcification."

"Astrositoma merupakan salah satu tumor otak primer terbanyak dengan mortalitas yang tinggi. Pemeriksaan MRI dan ADC dapat membantu menentukan derajat astrositoma sebelum dilakukan biopsi histopatologi sehingga edukasi mengenai tatalaksana dan prognosis pasien dapat dilakukan lebih dini. Metode: Penelitian potong lintang ini menggunakan data sekunder MRI kepala pasien dengan histopatologi astrositoma. Penilaian astrositoma dilakukan berdasarkan gambaran MRI menggunakan kriteria Dean dkk dan pengukuran ADC untuk seluruh bagian tumor (Ab) dan bagian tumor padat yang menyangat kontras (Ap) serta beberapa sampel (Ar) pada satu potongan terbesar di ADC map. Analisis data dilakukan untuk mendapatkan nilai diagnostik gambaran MRI dan ADC untuk menentukan derajat astrositoma berdasarkan sensitivitas, spesifisitas, dan kurva receiver operating characteristic (ROC). Hasil: Parameter gambaran astrositoma pada MRI yang bermakna untuk menentukan astrositoma derajat rendah dan tinggi adalah batas, perdarahan, dan heterogenitas. Penggunaan jumlah skoring kriteria Dean dkk pada gambaran astrositoma dengan nilai batas 7 serta penilaian gambaran astrositoma pada MRI untuk menentukan astrositoma derajat rendah dan tinggi memiliki sensitivitas 90,9% dan spesifisitas 87,5%. ADC dengan menggunakan nilai rerata, minimum, dan maksimum pada Ap serta nilai rerata dan minimum pada Ar berbeda bermakna untuk menentukan astrositoma derajat rendah dan tinggi dengan nilai sensitivitas dan spesifisitas masing-masing mencapai 90,9% dan 87,5%. Kesimpulan: MRI dan ADC memiliki sensitivitas dan spesifisitas tinggi untuk menentukan astrositoma derajat rendah dan tinggi.

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Astrocytoma is the most frequent primary brain tumor with high mortality. MRI and ADC could determine astrocytoma grading before histopathological biopsy performed, hence patient education for treatment and prognosis could be established more early.

Method: A cross-sectional research is performed using brain MRI of patients with astrocytoma as histopathological diagnosis. Astrocytoma evaluation using MRI image with Dean et al criteria and ADC measurement for all part of tumor (Ab), single (Ap) and multiple (Ar) solid part of tumor that enhance with contrast administration in one axial section of the largest part of the tumor. Data analysis is performed to obtain diagnostic value of MRI image and ADC to determine astrocytoma grade based on sensitivity, specificity, and receiver operating characteristic (ROC) curve.

Result: MRI image parameters that is significant to determine low and high grade astrocytoma are border, hemorrhage, and heterogeneity. The sum of astrocytoma image scoring of Dean et al criteria with cut-off value of 7 and the evaluation of astrocytoma image in MRI to determine low and high grade astrocytoma has 90,9% sensitivity and 87,5% specificity. ADC, for Ap and Ar, is significant to determine low and high grade astrocytoma with sensitivity up to 90,9% and specificity up to 87,5%.

Conclusion: MRI and ADC has high sensitivity and specificity to determine low and high grade astrocytoma."

"ABSTRAKLatar belakang dan tujuan : Trigeminal neuralgia (TGN) atau tic douloureux adalah rasa nyeri seperti ditusuk-tusuk pada satu sisi wajah. Prevalensi TGN 0,01% sampai 0,3%, angka kejadian 3,4 sampai 5,9 per 100.000 orang pertahun. 3D CISS MRI waktu akuisisi singkat, Signal to Noise Ratio tinggi, dan Contrast to Noise Ratio yang baik. Instrumen Pain Assessment Scale (PAS) yang digunakan adalah Pain Rating Scale (PRS) karena mudah digunakan, tersedia luas dan murah. PRS dapat dipertimbangkan sebagai instrumen penilaian perkiraan jarak Neurovascular compression terhadap Root Exit Zone (REZ).Metode : Penelitian retrospektif pada 32 subjek Trigeminal Neuralgia yang melakukan pemeriksaan 3D CISS MRI dalam rentang Januari 2013 sampai Januari 2016. Evaluasi 3D CISS MRI 32 subjek ditemukan 35 origin vaskular penyebab kompresi. Metode penelitian menggunakan uji korelatif dengan pendekatan potong lintang antara nilai PRS dengan jarak NC terhadap REZ yang dievaluasi menggunakan 3D CISS MRI.Hasil : Menggunakan tes Spearman terhadap 35 subjek kompresi diperoleh hasil terdapat korelasi antara nilai PRS dengan jarak NC terhadap REZ dengan rerata jarak kompresi 2,10 mm ± 2,10 (r = -0,39 dan p= 0,021). Dihasilkan formulasi regresi jarak kompresi 3,15 ? 0,47 x Skala nyeri.Kesimpulan : Terdapat korelasi antara nilai PRS dengan jarak NCterhadap REZ pada pasien Trigeminal neuralgia.

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ABSTRACTBackground and Objective: Trigeminal neuralgia or tic douloureuxis unilateral facial pain. TGN prevalence 0,01% to 0,3%, incidence rate 3,4 to 5,9 per 100.000 people a year. High signal to noise ratio and better contrast to noise ratio is 3D CISS MR benefits. Trigeminal pain evaluated with pain assessment scale because simple, less expensive and widely available. So it can be considered as an assessment instrument to estimates neurovascular compressiondistance related to trigeminal nerve root exit zone.Methods : This is a retrospective study on 32 subjects trigeminal neuralgia who had 3D CISS MR examination within January 2013 to January 2016. Evaluation 3D CISS MR found 35 vascular origin causes compression. This methods using correlative study with cross sectional between PAS value with neurovascular compression distance related to trigeminal nerve root exit zone.Results : From 35 subject compression with Spearman test there is moderate correlation between PAS value with neurovascular compression distance related to trigeminal nerve root exit zone (Mean 2.10 mm ± 2,10, r = -0,39 and p = 0,021) and result Regretion formulation 3,15 ? 0,47 x Pain scale.Conclusion : There is moderate correlation between PRS value with neurovascular compression distance related to trigeminal nerve root exit zone."

"Latar Belakang: Sklerosis multipel (multiple sclerosis/MS) merupakan penyakit inflamasi-demyelinasi sistem saraf pusat yang mengakibatkan atrofi struktur otak penderita. Indeks korpus kalosum (IKK) merupakan salah satu metode pengukuran morfometrik korpus kalosum yang cepat serta dengan reliabilitas interrater yang tinggi. Tujuan: Mengetahui korelasi antara hasil pengukuran IKK dengan volume korpus kalosum, substansi grisea kortikal, substansi grisea subkortikal, dan substansi alba serebri melalui MRI volumetri otak pada penderita MS. Metode : Hasil MRI kepala dari 30 penderita MS dilakukan pengukuran IKK. Nilai IKK kemudian dilakukan analisis korelasional dengan volume korpus kalosum, substansi grisea kortikal, substansi grisea subkortikal, dan substansi alba serebri yang diperoleh menggunakan perangkat lunak FreeSurfer©. Hasil : Terdapat korelasi yang sangat kuat antara IKK dengan volume korpus kalosum (R = 0,797 ; p = 0,001) dan volume substansi alba serebri (R = 0,813 ; p = 0,001). IKK juga berkorelasi kuat dengan volume substansi grisea kortikal (R = 0,642 ; p = 0,001) dan volume substansi grisea subkortikal (R = 0,696 ; p = 0,001). Kesimpulan : Metode pengukuran IKK dapat menjadi parameter morfometrik cepat dan sederhana yang menggambarkan volume korpus kalosum, substansi grisea kortikal, substansi grisea subkortikal, dan substansi alba serebri pada penderita MS.

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Background: Multiple sclerosis (MS) is an inflammatory-demyelinating disease of the central nervous system which results in atrophy of brain structure. Corpus callosum index (CCI) is a method of morphometric measurement of the corpus callosum using midsagittal slice from MRI which does not require additional sequences with fast processing time and high interrater reliability.

Objectives : To determine the correlation between the CCI measurements with corpus callosum, cortical gray matter, subcortical gray matter, and cerebral white matter volume through brain MRI volumetry in MS patients.

Methods : CCI measurements were obtained from head MRI from 30 MS patients according to the method conceived by Figueroa et al. Correlational analysis was carried out between CCI with corpus callosum, cortical gray matter, subcortical gray matter, and cerebral white matter volume obtained using FreeSurfer©.

Results : Very strong correlation was shown between CCI and corpus callosum volume (R = 0.797; p = 0.001) and cerebral white matter volume (R = 0.813; p = 0.001). CCI also shown strong correlation with cortical gray matter volume (R = 0.642; p = 0.001) and subcortical gray matter volume (R = 0.696; p = 0.001).

Conclusion : CCI can be a fast and simple morphometric parameter that describes the corpus callosum, cortical gray matter, subcortical gray matter, and cerebral white matter volume in MS patients."

"Latar Belakang: Edema peritumoral kerap dihubungkan dengan gejala neurologis dan progresivitas pada glioblasoma. Peran nilai Apparent Diffusion Coefficient (ADC) pada Magnetic Resonance Imaging (MRI), faktor demografi dan gejala klinis dalam memrediksi derajat edema peritumoral masih belum banyak diketahui, sehingga perlu telaah lebih lanjut. Tujuan: Menilai hubungan nilai ADC intratumoral, faktor demografi dan gejala klinis dengan derajat edema peritumoral. Metode: Studi crossectional dengan data sekunder di RSUPN Dr. Cipto Mangunkusumo pada tahun 2014-2022. Seluruh sampel memiliki hasil MRI dengan sekuens DWI-ADC. Setiap variabel bebas dan tergantung dianalisis secara bivariat menggunakan uji Chi-square; untuk variabel bebas dengan nilai p<0,25 dilakukan analisis multivariat. Derajat edema peritumoral pada MRI dibagi menjadi mayor (>1cm) dan minor (<1cm). Hasil: 78 pasien dianalisis; didapatkan hubungan yang bermakna antara nilai ADC intratumoral dengan derajat edema peritumoral pada nilai cut off  ≤0,75 x 10-3 mm2/s (p <0,001). Tidak terdapat hubungan antara usia ≤60 tahun, jenis kelamin, sakit kepala, penurunan kesadaran dan papil edema dengan derajat edema peritumoral, sedangkan usia >60 tahun mutlak mengalami edema mayor. Kesimpulan: Pasien dengan nilai ADC ≤0,75 x 10-3 mm2/s memiliki kemungkinan mengalami edema peritumoral mayor lebih besar.

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Background: Peritumoral edema is often associated to neurological symptoms and progression in glioblastoma. The role of the Apparent Diffusion Coefficient (ADC) in Magnetic Resonance Imaging (MRI), demographic and clinical symptoms in predicting the degree of peritumoral edema not much known, so further studies are needed.

Objective: To assess the relationship between intratumoral ADC value, demographic and clinical symptoms with the degree of peritumoral edema.

Methods: Cross-sectional study with secondary data at RSUPN Dr. Cipto Mangunkusumo in 2014-2022. All samples had MRI with DWI-ADC sequence. Each independent and dependent variable was analyzed bivariately using the Chi-square test; independent variables with p <0.05, multivariate analysis was performed. Peritumoral edema on MRI are divided into major (>1cm) and minor (<1cm).

Results: 78 patients were analyzed; a significant relationship was found between intratumoral ADC value and degree of peritumoral edema at cut-off value of ≤0.75 x 10-3 mm2/s (p <0.001). There is no relationship between age ≤60, gender, headache, loss of consciousness and papilledema with the degree of peritumoral edema, whereas age >60 years has absolute major edema.

Conclusion: Patients with ADC values ≤0.75 x 10-3 mm2/s have a greater likelihood of developing major edema."

"Latar belakang: Penyakit ginjal kronik sendiri dapat menjadi faktor risiko penyakit serebrovaskular karena ginjal dan parenkim otak memiliki kemiripan pembuluh distal (pada nefron dan arteriole di otak). Pembuktian korelasi antara penyakit ginjal kronik terhadap CSVD dapat dilakukan melalui evaluasi penurunan nilai laju filtrasi glomerulus (LFG) dan evaluasi temuan MRI kepala.Metode: Studi ini merupakan studi korelasi potong lintang dengan evaluasi MRI kepala dan penilaian sesuai acuan STRIVE, kemudian ditentukan korelasi terhadap rerata nilai estimasi laju filtrasi glomerulus penderita.Hasil: Terdapat korelasi negatif antara penyakit ginjal kronik terhadap CSVD (r = - 0,39 dan p = 0,029). Nilai median total skor CSVD adalah 2,5 dengan rerata nilai estimasi LFG pada penelitian ini 40 ml/menit per 1,73 m2.Kesimpulan: Terdapat korelasi negatif antara penyakit ginjal kronik terhadap CSVD. Diperlukan penelitian lanjutan dengan jumlah sampel lebih besar untuk menentukan nilai estimasi LFG yang menjadi cut-off point bagi pasien untuk menjalani MRI kepala, serta untuk mengetahui kaitan total skor CSVD dengan faktor risiko lainnya.

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Background: Cerebral Small Vessel Disease (CSVD) and chronic kidney disease (CKD) have similar and overlapping risk factors. CKD itself can be a risk factor for cerebrovascular diseases because of the similarities between small vessels in the brain and kidneys (nephrons). Correlation between CKD and CSVD can be proven by evaluating estimated GFR values and head MRI quantitatively.

Method: This study was a cross sectional study to determine the correlation between mean estimated GFR values in CKD and quantitative head MRI evaluation of CSVD. Result: There was a weak negative correlation between mean estimated GFR values with CSVD. Median of total score CSVD from all subjects were 2,5 with mean estimated GFR values was 40 ml/minutes per 1,73 m2 (range 4,6 – 59 ml/minutes per 1,73 m2). Conclusion: There was negative correlation between CKD and CSVD. Further studies are needed with larger sample to determine cut off point for estimated GFR values to perform head MRI in CSVD, also to determine relationship of CSVD total score with other risk factors."

"Latar belakang: Pemeriksaan MRI pada glioblastoma dapat membantu diagnosis dengan tingkat akurasi tinggi. Nilai ADC pada MRI bisa menjadi indikator prognosis, meskipun belum sering diterapkan di Indonesia. Penelitian ini dilakukan untuk memahami peran nilai ADC dalam meningkatkan prediksi kesintasan pasien glioblastoma.Tujuan: Mengkaji angka kesintasan pasien glioblastoma yang mendapatkan terapi kemoradiasi serta hubungannya dengan nilai ADC dan faktor lainnya.Metode: Angka kesintasan dan nilai ADC minimum diambil dari pemeriksaan MRI kepala post-operasi, pre-kemoradiasi pada 20 pasien dari periode 2017 hingga 2023 yang memenuhi kriteria penelitian. Analisis kesintasan dilakukan dengan metode Kaplan-Meier. Uji Log Rank digunakan untuk mengevaluasi pengaruh faktor-faktor determinan termasuk nilai ADC terhadap kelangsungan hidup.Hasil: Rerata usia sampel dalam pemelitian ini adalah 43,6 +/- 16,4 tahun. Terdapat 14 pasien laki-laki (70%), dan 6 pasien perempuan (30%). sebanyak 6 pasien (30%) memiliki nilai ADC ≥ 0,8 x 10-3 mm2/s dan terdapat 14 pasien (70%) memiliki nilai ADC < 0,8 x 10-3 mm2/s. Analisis kesintasan memperlihatkan perbedaan median kesintasan hidup pada kelompok nilai ADC ≥ 0,8 x 10-3 mm2/s dan < 0,8 x 10-3 mm2/s, yaitu sebesar 12 bulan dan 10 bulan dengan nilai p=0,850.Kesimpulan: Pasien dengan nilai ADC < 0,8 x 10-3 mm2/s memiliki tren kesintasan yang lebih singkat dua bulan dibandingkan dengan pasien dengan nilai ADC ≥ 0,8 x 10-3 mm2/s yang masing-masing median kesintasannya sebesar 10 bulan dan 12 bulan.

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Background: MRI examinations for glioblastoma can aid in diagnosis with a high level of accuracy. The Apparent Diffusion Coefficient (ADC) value in MRI can serve as a prognostic indicator, although it has not been widely applied in Indonesia. This study was conducted to understand the role of ADC values in improving the prediction of survival in glioblastoma patients.

Objective: To examine the survival rates of glioblastoma patients undergoing chemoradiation therapy and its relationship with ADC values and other factors.

Methods: Survival rates and minimum ADC values were extracted from post- operative, pre-chemoradiation head MRI examinations of 20 patients meeting the study criteria from the period 2017 to 2023. Survival analysis was performed using the Kaplan-Meier method, and the Log Rank test was employed to evaluate the impact of determinants, including ADC values, on survival.

Results: The mean age of the sample in this study was 43.6 +/- 16.4 years. There were 14 male patients (70%) and 6 female patients (30%). Six patients (30%) had ADC values ≥ 0.8 x 10-3 mm2/s, while 14 patients (70%) had ADC values < 0.8 x 10-3 mm2/s. Survival analysis revealed a median survival difference in the ADC ≥ 0.8 x 10-3 mm2/s and < 0.8 x 10-3 mm2/s groups, namely, 12 months and 10 months, with a p-value of 0.850.

Conclusion: Patients with ADC values < 0.8 x 10-3 mm2/s had a trend of two months shorter survival compared to patients with ADC values ≥ 0.8 x 10-3 mm2/s whose median survival was 10 months and 12 months."

"ABSTRAKLatar Belakang. Kejang merupakan gejala yang sering ditemukan pada tumor primer intrakranial dan penyebab utama morbiditas terhadap pasien.Pemeriksaan EEG diperlukan untuk menentukan kesesuaian antara fokus kejang dengan lokasi tumor pada MRI yang akan menentukan prognosis kejang serta banyak faktor-faktor yang mempengaruhi kesesuaian antara fokus kejang dengan lokasi tumor. Belum adanya data mengenai kejang pada tumor primer intrakranial serta kesesuaian berdasarkan gambaran EEG dan MRI menjadi dasar dilakukannya penelitian ini. Tujuan.Mengetahui kesesuaian antara aktivitas epileptiform pada EEG dan lesi tumor dengan MRI pada pasien tumor primer intrakranial dengan klinis kejang. Metode.Desain penelitian berupa studi potong lintang (cross sectional).Subyek penelitian adalah semua pasien dengan tumor primer intrakranial yang ada di ruang rawat inap dan rawat jalan neurologi, bedah saraf, radiologi RS Cipto Mangunkusumo yang sudah dilakukan EEG dan MRI.Ditentukan aktivitas epileptiform dan dianalisa kesesuaiannya dengan lokasi tumor berdasarkan MRI. Hasil.Dari 33 subyek dengan tumor primer intrakranial dengan klinis kejang , didapatkan hanya 17 subyek yang menunjukkan aktivitas epileptiform (51,5%), perempuan lebih banyak dari lelaki, dengan rerata usia adalah 34 tahun. Sebagian besar mengalami kejang parsial dan secondary generalized seizure(SGS) merupakan tipe kejang parsial terbanyak (16 dari 17 subyek). Kejang sering ditemukan pada tumor di frontal (11 dari 17 subyek) dan pada jenis tumor primer Low grade(8 dari 17 subyek). Kesesuaian aktivitas epileptiform dengan lokasi tumor didapatkan pada 8 dari 17 subyek dengan lebih banyak yang sesuai pada lobus temporal. Kesimpulan.Dari seluruh pasien tersangka tumor primer intrakranial dengan klinis kejang hanya didapatkan 8 dari 17 subyek yang sesuai antara aktivitas epileptiform pada EEG dengan lesi tumor pada MRI.Gambaran aktivitas epileptiform pada EEG tidak dipengaruhi oleh usia, bentuk bangkitan kejang, jenis tumor, lokasi berdasarkan lobus, lokasi berdasarkan parenkim otak, durasi sakit, dan ukuran tumor.

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ABSTRATBackground.Seizures are a common symptom in primary intracranial tumors and a major cause of morbidity to the patient. EEG examination is necessary to determine the suitability of the seizure focus to the location of the tumor on MRI that will determine the prognosis of seizures as well as a lot of factors that affect compatibility between focal seizures with tumor location. The absence of data on seizures in primary intracranial tumors and suitability based on EEG and MRI picture is the basis of this study. Purpose.Knowing the correspondence between epileptiform activity on EEG and MRI tumor lesions in patients with primary intracranial tumors with clinical seizures. Method.Design research is a cross-sectional study (cross-sectional). Subjects were all patients with primary intracranial tumors that exist in the inpatient and outpatient neurology, neurosurgery, radiology Cipto Mangunkusumo already done EEG and MRI. Epileptiform activity determined and analyzed for compliance with the location of the tumor by MRI. Result. From 33 subjects with primary brain tumors with clinical seizures, obtained only 17 subjects demonstrated epileptiform activity (51.5%), more women than men, with a mean age was 34 years. Most had partial seizures and secondary generalized seizures (SGS) is a type of partial seizure majority (16 of 17 subjects). Seizures are often found in tumors in the frontal (11 of 17 subjects) and the type of primary tumor Low grade (8 of 17 subjects). Suitability of epileptiform activity by tumor location obtained in 8 of 17 subjects with more appropriate in the temporal lobe. Conclusion.From all patients suspected of primary brain tumors with clinical seizures obtained only 8 of the 17 subjects that fit between epileptiform activity on EEG with tumor lesions on MRI. Picture of epileptiform activity on EEG was not influenced by age, shape seizures, tumor type, location based lobes, based on the location of the brain parenchyma, duration of illness, and tumor size."