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"The idea of using the enormous potential of magnetic resonance imaging (MRI) not only for diagnostic but also for interventional purposes may seem obvious, but it took major efforts by engineers, physicists, and clinicians to come up with dedicated interventional techniques and scanners, and improvements are still ongoing. Since the inception of interventional MRI in the mid-1990s, the numbers of settings, techniques, and clinical applications have increased dramatically. This state of the art book covers all aspects of interventional MRI. The more technical contributions offer an overview of the fundamental ideas and concepts and present the available instrumentation. The richly illustrated clinical contributions, ranging from MRI-guided biopsies to completely MRI-controlled therapies in various body regions, provide detailed information on established and emerging applications and identify future trends and challenges."

"Encompassing the entire spectrum of breast imaging and diagnostics, this acclaimed text provides a systematic and pragmatic guide for all clinicians involved in diagnosing breast disease. The new third edition has been fully updated to include advances in mammography, ultrasound, breast MRI, percutaneous interventions, and emerging technologies, with pros and cons and evidence-based approaches throughout. Special features of the third edition: Coverage of the field, with comprehensive sections on examination procedures and technical requirements; histologic, clinical, and radiologic appearance of a wide range of breast pathologies; results of international screening studies; and much more. Nearly 1,200 clear radiographic images showing normal findings, benign and malignant disorders, and post-traumatic, post-surgical, and post-therapeutic changes to the breast. Innovations in digital mammography, tomosynthesis, and computer assisted detection (CAD); new chapters on imaging of implants, lesions of uncertain malignant potential, developing technologies; and more. A systematic, highly reproducible methodology for detection, diagnosis, and assessment of findings. Easy-to-follow flowcharts for the diagnostic work-up of both typical and atypical cases. Written by world-renowned authorities with decades of clinical experience, this book provides a brilliant orientation to the multimodality diagnostic approach and therapeutic significance of breast imaging findings. It is an essential reference and board review for radiologists, residents and fellows, gynecologists, oncologists, surgeons, technologists, and any other interdisciplinary specialist working to improve outcomes in breast disease"

"Renowned for its superb illustrations and highly practical information, the third edition of this classic reference reflects the very latest in state-of-the-art imaging technology. Together with Volumes 2 and 3, this compact and portable book provides a highly specialized navigational tool for clinicians seeking to master the ability to recognize anatomical structures and accurately interpret CT and MR images."

"Pada skripsi ini dirancang sebuah resonator RF Birdcage Coil tanpa lumped circuit untuk aplikasi sistem Magnetic Resonance Imaging (MRI). MRI merupakan teknologi pencitraan tubuh manusia untuk aplikasi diagnosis medis yang bersifat non-invasive dan tidak memiliki pengaruh radiasi foton seperti halnya yang terdapat pada sistem Computed Tomography (CT). MRI memanfaatkan efek kuat medan magnet untuk mensejajarkan susunan inti atom hidrogen (proton) dengan arah medan magnet eksternal. Pada saat yang bersamaan sistem memancarkan RF Pulse ke tubuh pasien kemudian menerima sinyal Magnetic Resonance (MR) untuk rekonstruksi citra penampang tubuh. Pada penilitian ini dirancang suatu resonator RF Birdcage Coil tanpa lumped circuit yang beresonansi di spektrum frekuensi 128 MHz. Secara desain, resonator ini dirancang terdiri atas Leg dan End Rings (ERs) terbuat dari selembar konduktor tembaga tipis yang ditempelkan di kedua sisi akrilik sebagai material substrat untuk memberikan nilai kapasitansi resonator dan sekaligus sebagai pembentuk konfigurasi resonator RF Birdcage Coil. End Rings disusun superposisi untuk membentuk kapasitor secara bergantian. Untuk mendapatkan frekuensi resonansi yang diinginkan, dilakukan tuning dengan cara memperbesar atau memperkecil dimensi plat tembaga End Rings untuk mengubah nilai kapasitansi resonator. Desain resonator dirancang dengan menggunakan perangkat lunak Birdcage Builder untuk menghitung nilai kapasitansi awal dan disimulasikan dengan perangkat lunak berbasis Finite Integration Technique (FIT). Setelah dilakukan validasi dengan cara pengukuran tanpa ada tubuh manusia, resonator dapat beresonansi di frekuensi 128,5 MHz. Pengujian resonator dengan memasukkan bagian tubuh manusia seperti kepala dan tangan, resonator memberikan response perubahan yang sangat kecil pada pergeseran frekuensi berturut-turut 128,8 MHz dan 127,7 MHz untuk kepala dan tangan manusia.

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In this final project the RF Birdcage Coil resonator is designed without using lumped circuit for application of Magnetic Resonance Imaging (MRI) system. MRI is a scanning technology of human body tissues to medical diagnosis application which generally is non-invasive and doesn’t has the impact of photon like another system such as Computed Tomography (CT). It utilizes the effect of magnetic field strength to aligns proton with external magnetic field and transmits the RF Pulse to the human body then recieves the Magnetic Resonance (MR) signal for image reconstruction simultaneously.

In this research the RF Birdcage Coil resonator is designed without using lumped circuit and it can resonance in 128 MHz. This resonator has the Leg and End Rings which is made from copper foil and attached to the inner and outer of acrylic as a substrat material to produce the capacitance of the resonator and also as a shaper of the RF Birdcage Coil’s configuration. The End Rings arrange superposition to create the capacitance respectively. To get desired resonance frequency it should be tuned by make dimension foil of End Rings bigger or smaller to change the capacitance.

Birdcage Builder as a software which used to design the beginning form of the resonator and count the first value of capacitance then simulated in software based on Finite Integration Technique. After validation with measurement without human body the resonator can resonance in 128,5 MHz. Measurement with import body parts such as head and hand into resonator give the smallest change in 128,8 MHz and 127,7 MHz for human head and hand respectively."

"Pada saat ini, teknologi elektromagnetik terapan telah digunakan di berbagai bidang, termasuk di bidang kesehatan. Teknologi ini banyak diaplikasikan untuk melakukan proses analisa suatu penyakit atau bahkan melakukan penyembuhan. Dari banyak kegunaan itu, salah satu aplikasi teknologi elektromagnetik terapan di bidang medis adalah sistem pencitraan penampang tubuh. Dari beberapa instrumen kesehatan yang berfungsi untuk menampilkan pencitraan penampang tubuh, Magnetic Resonance Imaging (MRI) memiliki keunggulan untuk melakukan pencitraan organ-organ lunak. Pengaplikasian teknologi MRI terus berkembang hingga sekarang termasuk teknik penggunaan RF Coil Resonator yang terdapat di sistem MRI.Pada skripsi ini akan dirancang bangun sebuah RF Coil Resonator untuk sistem MRI 3 Tesla agar dapat menghasilkan citra atau penggambaran dari objek yang lebih jelas dan dapat digunakan oleh tenaga medis seperti dokter sebagai acuan untuk menganalisa suatu jaringan lunak yang bermasalah. Penelitian ini merancang sebuah resonator phased array yang terdiri dari 8 elemen yang bekerja pada frekuensi 127,7 MHz. Berdasarkan hasil simulasi, resonator tersebut memiliki keseragaman medan magnet dan nilai Specific Absorption Rate (SAR) dibawah ambang batas aman yaitu 0,195 W/kg. Diharapkan hasil rancangan ini dapat bekerja secara paralel untuk meningkatkan fungsionalitas dan kemampuan sistem MRI yang menghasilkan suatu citra yang lebih baik dan waktu scanning yang lebih cepat dibandingkan dengan resonator konvensional. Resonator phased array coil ini telah difabrikasi dan diukur parameter S-parameter dengan hasil yang sesuai dengan hasil simulasi pada frekuensi kerja 127,67 MHz.

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Currently, applied electromagnetic technology has been used in various fields, including for health sector. This technology is widely adopted for disease diagnosis as well as for treatment. One of several applications in applied electromagnetic technology is imaging system for medical field application. One of medical instruments which are used for body imaging system, that is Magnetic Resonance Imaging (MRI), has the advantage to create an image of soft organ. Application of MRI technology continues to evolve up until now, including the development of RF Coil Resonator techniques for MRI systems.

In this thesis, a RF Resonator Coil for 3 MRI 3 Tesla system is designed in order to produce high-resolution images, so it can be used by medical personnel such as doctors to analyze the soft tissue problems.

In this study, a RF phased array resonator that consists of 8 elements is designed for working at the frequency of 127.7 MHz. According to the simulation results, the resonator has uniform magnetic field and low value of Specific Absorption Rate (SAR) below the safety threshold by 0.195 W / kg.

It is expected that this design is able to operate for parallel operation in order to increase the functionality and capability of the MRI system can produces a better image and a faster scanning time in comparison with the conventional resonator one. The phased array coil resonator has been fabricated and measured, where the Sparameter results agree with the simulation results at the operation frequency 127.67 MHz."

"Latar belakang: Kanker endometrium merupakan kasus kanker baru terbanyak ke dua pada organ ginekologi setelah kanker serviks. Kanker endometrium dikategorikan menjadi dua: tipe I (estrogen related) dan tipe II (nonestrogen related). Kanker endometrium tipe I merupakan kasus tersering dari kanker endometrium. Manajemen utama untuk kanker endometrium adalah operasi. Tindakan operasi dan terapi adjuvan kasus kanker endometrium tipe I dipengaruhi beberapa variabel yang dapat dinilai preoperasi. Invasi miometrium dan keterlibatan serviks merupakan variabel preoperasi yang penting pada kanker endometrium tipe I. Magnetic resonance diffusion weighted imaging merupakan metode yang menjanjikan dalam menilai invasi miometrium dan keterlibatan serviks.Metode: Penelitian cross-sectional dilakukan untuk menganalisis hasil magnetic resonance diffusion weighted imaging dalam menilai invasi miometrium dan keterlibatan serviks. Penelitian ini melibatkan semua pasien kanker endometrium tipe I di RSUP Dr. Cipto Mangunkusumo dari April 2016 hingga April 2019. Invasi miometrium dan keterlibatan serviks diperiksa menggunakan mesin MRI 1,5 T. Hasil pemeriksaan dibandingkan dengan histopatologi sebagai standar.Hasil: Sebanyak 34 pasien dilibatkan dalam penelitian ini. Rentang usia pasien berkisar dari 22 hingga 73 tahun. Hasil histopatologi semua pasien yang dimasukkan dalam penelitian ini adalah kanker endometrium tipe I. Pemeriksaaan menggunakan magnetic resonance diffusion weighted imaging memberiksan hasil 22 pasien (64,7%) dengan kedalaman invasi miometrium lebih dari 50% dan 12 pasien (35,3%) dengan kedalaman invasi miometrium kurang dari 50%; 6 pasien (17,6%) dengan keterlibatan serviks dan 28 pasien (82,4%) tidak ada keterlibatan serviks. Hasil histopatologi menunjukkan 17 pasien (50%) dengan kedalaman invasi miometrium lebih dari 50% maupun kurang dari 50%; 7 pasien (20,6%) dengan keterlibatan serviks dan 27 pasien (79,4%) tidak ada keterlibatan serviks. Sensitivitas dan spesifisitas magnetic resonance diffusion weighted imaging dalam menilai invasi miometrium pada kanker endometrium tipe I adalah 94,12% dan 64,71%, secara berurutan. Sensitivitas dan spesifisitas magnetic resonance diffusion weighted imaging dalam menilai keterlibatan serviks pada kanker endometrium tipe I adalah 57,14% dan 92,59%, secara berurutan.Simpulan: Magnetic resonance diffusion weighted imaging dapat memberikan informasi prognostik yang cukup baik mengenai invasi miometrium dan keterlibatan serviks pada pasien kanker endometrium.

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Background: Endometrial cancer is the second most common new case reproductive organ cancer in the world after cervical cancer. Two different clinicopathologic subtypes of endometrial cancer are categorized: estrogen related (type I) and nonestrogen related (type II). Type I endometrial cancer accounts for approximately 75 percent of all endometrial cancer cases. Primary management for endometrial cancer is surgery. Operation procedure and adjuvant treatment of type I endometrial cancer were affected by some variables assessed preoperatively. Myometrial invasion and cervical involvement are important prognostic variables in type I endometrial cancer. Magnetic resonance diffusion weighted imaging is promising in evaluation of myometrial invasion and cervical involvement.

Methods: We conducted a cross-sectional study to analyze the result of magnetic resonance diffusion weighted imaging in evaluating myometrial invasion and cervical involvement. This study involved all type I endometrial cancer patients in Dr. Cipto Mangunkusumo Hospital from April 2016 until April 2019. The depth of myometrial invasion and cervical involvement was examined using 1,5-T MR unit. The result was compared to the surgical pathologic findings as the reference standard.

Result: 34 patients were enrolled in this study. Patient age was ranged from 22 until 73 years old. All of the patient pathologic findings were type I endometrial cancer. Evaluation using magnetic resonance diffusion weighted imaging showed 22 patients (64,7%) had ≥ 1/2 myometrial invasion and 12 patients (35,3%) had < 1/2 myometrial invasion; 6 patients (17,6%) had cervical involvement and 28 patients (82,4%) had not cervical involvement. Based on surgical pathologic findings, there were 17 patients (50%) had ≥ 1/2 myometrial invasion and also for the patient with < 1/2 myometrial invasion; 7 patients (20,6%) had cervical involvement and 27 patients (79,4%) had not cervical involvement. Sensitivity and specificity of magnetic resonance diffusion weighted imaging to evaluate myometrial invasion in type I endometrial cancer were 94,12% and 64,71%, respectively. Sensitivity and specificity of magnetic resonance diffusion weighted imaging to evaluate cervical involvement in type I endometrial cancer were 57,14% and 92,59%, respectively.

Conclusion: Magnetic resonance diffusion weighted imaging can provide reliable prognostic variable information about myometrial invasion and cervical involvement in preoperative preparation of endometrial cancer patients.

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"Magnetic resonance imaging selanjutnya disebut MRI merupakan peralatan radiologi diagnostik yang tidak mengandung radiasi pengion. Hal tersebut tidak berarti menjadikan alat ini bebas dari potensi bahaya. Penelitian ini ditujukan untuk mendapatkan deskripsi, menganalisa dan menilai penerapan keselamatan lingkungan pada fasilitas MRI 1.5T di wilayah DKI Jakarta. Penelitian didesain dengan metode campuran dengan tehnik purposive sampling. Dilaksanakan pada 4 fasilitas MRI 1.5T di wilayah DKI Jakarta dengan jumlah responden sebanyak 25 (dua puluh lima) orang radiografer yang bertugas di pelayanan MRI. Data kuantitatif diuji dengan menggunakan uji statistik nonparametrik yaitu Cochran’s Q dan Kruskalwalis. Nilai Cochran’s Q hitung>Chi square tabel (66.495>36.415) sehingga H0 ditolak atau terdapat perbedaan pemahaman radiografer. Uji statistik kruskalwalis menunjukkan nilai mean rank antar rumah sakit sumber data bervariasi. Data kualitatif terkait ketersediaan perangkat keselamatan menunjukkan standar American Collage of Radiology (ACR) lebih aplikatif dibandingkan standar Keputusan Menteri Kesehatan (KMK) RI No. 410/MENKES/SK/III/2010 tentang standar pelayanan radiologi diagnostik di sarana pelayanan kesehatan. Keempat rumah sakit sumber data telah memenuhi standar ACR sedangkan standar KMK 410/2010 hanya dapat dipenuhi oleh sebagian. Kepatuhan petugas dalam praktek aman penanganan pasien mandiri di empat rumah sakit sumber data telah memenuhi standar ACR dengan nilai bervariasi.

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Magnetic resonance imaging is hereinafter referred to MRI as diagnostic radiology equipment that contains no ionizing radiation. That does not mean to make this tool is free of potential hazards. This study aimed to get a description, analyze and assess the implementation of environmental safety at 1.5T MRI facility in Jakarta. The research is designed with a mix method with purposive sampling technique. Held on 4 (four) 1.5T MRI facilities in Jakarta. The number of respondents as many as 25 (twenty five) radiographers who served in MRI services. The quantitative data were tested using nonparametric statistical test that Cochran's Q and Kruskalwalis . Cochran's Q value count > Chi square table (66 495> 36 415) so that H0 is rejected or there is a difference of understanding radiographer. Kruskalwalis statistical test shows the mean rank among hospitals varied data sources. The qualitative data related to the availability of safety devices demonstrate the American Collage Of Radiology (ACR) standards more applicable than Keputusan Menteri Kesehatan (KMK) RI No. 410/MENKES/SK/III/2010 standard. The fourth hospital data sources meet the standard ACR while KMK 410/2010 standard can only be met by the majority. Compliance officers in the safe practice of self-management of patients in four hospitals have a data source meets ACR standards with varying grades."

"ABSTRAKPenelitian ini bcrtujuan unluk mendapat gambaran tcntang utilisasi alat mediscanggih MRI di RSPAD Gatot Soebroto sehingga bcrguna bagi manajcmcn rumah sakitdan Ditkes Ditjen Kuathan Dcphan sebagai pelaksana pengadaan untuk RS TNI scrtasejauh mana MRI dapat digunakan dan dimanfaatkan khususnya oleh anggota TNI, PNSserta keluarganya dan pasien umum lainnya dan untuk mengetahui pcndapatan, biayascrta tingkat pemulihan biaya alat canggih MRI di RSPAD tahun 2006.Dari hasil penelitian diketahui bahwa selama tahun 2006 jenis pemenksaan MRIyang paling banyak dilakukan adalah MRI Vertebra cervical / thoracal I lumbbsacralsebanyak 1029, kemuclian MRI Kcpala sebanyak 803 dan MRI Abdomen bagian atassebanyak 46 kali. Total jumlah pasien keseluruhan tahun 2006 adalah 4582 pasiun.Jumlah pasien yang menjalani pemeriksaan MRI terbauyak adalah masyamkat umum(Yanmasum) yaiiu sebanyak 2545 pasien. Biaya pemcriksaan MRI bagi pasien dinas dariTNI AD tidak dipungut biaya apapun, sedangkan pasien dinas dari TNI AU dan TNI ALdikcnakan biaya sebesar 50% dari tarif yang berIaku.Pendapatan Unit MRI berasal daripasien Askes dan pasien umum serta pasien dinas TNI AL dan TNI AU. Pendapatan yangdiperoleh tahun 2006 adalah scbcsar Rp2.877.500.606. Biaya yang terkail dengan UnitMRI bcnjumlah 2.861.475.228. Pendapatan alat kesehatan MRI sudah menutup biayayang dikeluarkan dengan sisa pendapatan scbcsar Rpl6.025.378 . Hal ini ditunjukkandcngan lingkat pemulihan biaya alat MRI yang sudah mencapai l00,56%.Dengan dikctahuinya gambaran utilisasi, biaya yang dikeluarkan dan pendapatanunit MRI di lnstalasi Radiologi RSPAD Gatot Soebroto, maka manajemen dapatmclakukan evaluasi tarif berdasarkan perhitungan biaya satuan pemcniksaan yangkomprehensif yang juga dapat digunakan sebagai bahan revisi bcsamya tarif sehinggadapal mencapai tingkut pemulihan biaya yang diharapkan. Perlu dilakukan upayapcningkatan utilisasi alat canggih MRI mclalui kegiatan sosialisasi, seminar untuk dapatmemasarkan jenis pemeriksaan-pemeriksaan dengan alat MRI, dilakukan kerja samadengan rumah sakit lain yang tidak mcmiiiki peralalan MRI, sehingga peningkatankunjungan teljadi pada pasien umum, dilakukan sistem penjanjian, sehingga idle capasitydi tengah jam kerja dapat diperkecil. Selain iiu perlu dijalin kerjasama antara PT Askesdengan Unit MR] yang saling menguntungkan, karena biaya pemanfaatan alat canggihmerupakan biaya yang dianggap cukup besar bagi pasien. Perlu perencanaan biaya pemeliharaan dan perbaikan scrta kalibmsi alat kcsehatan dan sarana penunjangnya BagiInstitusi Dcphan gambaran utilisasi, biaya satuan pemeriksaan dan pendapatan unit MRIdi Insmlasi Radiologi RSPAD Gatot Soebroto dapat digunakan sebagai bahan masukanpengadaan alat kesehatan caxmgih lainnya di linglcungan Dcphan. Perlu dilakukanpenelitian lanjutan yang lebih komprchensif terhadap alat canggih kesehatan dengnnmenggunakan data yang lebih mcmadai baik dari segi kelengkapan data maupunkeakuralannya.

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ABSTRACTThis research aimed to get the description 'about the utilization of the medicalequipment sophisticated MRI in RSPAD Gatot Soebroto especially the utilization of MRIby the TNI member, PNS as well as his family and the public's other patient and therevenue, cost and cost recovery rate of MRI in RSPAD in 2006.From results of this research was known that during 2006 the MRIexaminations that often was carried out was MRI Vertebra cervical/thoracal/lumbosacralwas 1029, afterwards MRI Head was 803 aIId MRI Abdomen the upper partwas 46times. The total number of the whole patient in 2006 was 4582 patients. The number ofpatients who underwent the MRI examination most was the public patient (Yanmasum)that was 2545 patients. The MRI examination cost for the service patient from TNI ADwas not adopted the cost anything, whereas the service patient from TNI AU and TNI Alwas put on the cost of 50% ofthe tariff that available.Revenue of Unit MRI came from the patient of health insurance and the public'spatient as well as the service patient 'INI Al and TNI AU. Revenue that was received in2006 was Rp2.877.500.606. The cost that was related to the MRI Unit was2,86l,475,228. The income of the MRI medical instrument has closed the cost that wasspent with income as big as RpI6.025.378. This was shown with the MRI recovery rateof the implement cost that has reached 100.56%The management could carry out the evaluation of the tariff was based on thecalculation ofthe comprehensive cost of the examination unit that also could be used asthe revision material of the tariff size to be able to achieve the cost recovery rate that washoped for. Must be carried out by increase efforts of utilization of the MRI through thesocialization activity, the seminar to be able to market the kind of examinations with theMRI implement, was carried out by the work was the same as the other hospital that didnot have MRI equipment, so as the increase in the visit happened to the public's patient,was carried out by the agreement system, so as idle capasity in the middle ofthe workinghorns could be reduced.Moreover must be established by the co~opcration between PT Askes and theMRI Unit that was mutually beneficial. Needed planning and the improvement as well ascalibration of the medical instrument and means of the maintenance?s cost. For theDephan Institution, the cost and the income of the MRI unit could be used as theprocurement input of the other sophisticated medical instrument in the Dephan.

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