Studi Kasus Pemeriksaan MSCT Urografi Multiphase dengan Klinis Tumor Ginjal

Background: The procedure for examining multi-slice computed tomography (MSCT) multiphase urography with clinical kidney tumors in the Radiology Installation of the Banyumas General Hospital differs from the literature in the use of scans in the corticomedullary phase and the post-contrast scanning phase. This study aims to determine the procedure for MSCT Urography Multiphase examination with clinical kidney tumors, to find out the reasons for using a scan of the corticomedullary phase area from the diaphragm to the pubic symphysis and to find out the reasons for using four phases of post-contrast scanning.Methods: This type of research is qualitative research with a case study approach. Data was collected at the radiology installation at the Banyumas Hospital from January to May 2023, the study respondents consisted of three radiographers, one radiologist, one sending doctor and one radiology nurse. Methods of data collection by observation, in-depth interviews, documentation. Data analysis was carried out through the stages of data collection, data reduction, data presentation and drawing conclusions.Results: MSCT Urography Multiphase examination procedure with clinical kidney tumors in the radiology installation of Banyumas Hospital includes, the patient's supine feet first position, scanning area from the diaphragm to the symphysis pubis, using 50 ml of contrast media with 40 ml of saline flush. Scanning technique by taking the pre-contrast phase, corticomedullary phase, nephrography phase, equilibrium phase and delay phase. Scan the area of the corticomedullary phase from the diaphragm to the symphysis pubis to to simplify the scanning process because the tool protocol has already made full abdominal scan area settings and to evaluate the pattern of abdominal organ enhancement if there is a metastatic urothelial lesion other than the kidney. The use of four phases of post-contrast scanning is because the goals and functions of each scanning phase are different so that the maximum diagnostic information is obtained.Conclusions: The MSCT Urography Multiphase examination procedure with clinical kidney tumors in the radiology installation of Banyumas can provide optimal diagnostic information.

End-to-End Discriminative Deep Network for Liver Lesion Classification

Colorectal liver metastasis is one of most aggressive liver malignancies. While the definition of lesion type based on CT images determines the diagnosis and therapeutic strategy, the discrimination between cancerous and non-cancerous lesions are critical and requires highly skilled expertise, experience and time. In the present work we introduce an end-to-end deep learning approach to assist in the discrimination between liver metastases from colorectal cancer and benign cysts in abdominal CT images of the liver. Our approach incorporates the efficient feature extraction of InceptionV3 combined with residual connections and pre-trained weights from ImageNet. The architecture also includes fully connected classification layers to generate a probabilistic output of lesion type. We use an in-house clinical biobank with 230 liver lesions originating from 63 patients. With an accuracy of 0.96 and a F1-score of 0.92, the results obtained with the proposed approach surpasses state of the art methods. Our work provides the basis for incorporating machine learning tools in specialized radiology software to assist physicians in the early detection and treatment of liver lesions