Beruflich Dokumente
Kultur Dokumente
- Bone Scanning
- Cardiac Scanning
- Renal Scanning/ Renogram
- Thyroid Scanning
- Whole Body Sc. dsb
3. ULTRASOUND
a. Ultrasonography
Thyroid
- Abdomen
- Mammae dsb
- Cardiac
- Transvaginal, transrectal
- Endoscopic
b. Colour Doppler Ultrasonography
4. M R I
THERAPI
1. X Ray - Brachy
Therapy
Ray - External
Radiasi
a. Ortho Voltage
b. Medium Voltage
c. Mega Voltage
2. Radio Isotop - I 131
3. Ultra Sound -
Punctie,Guiding FNA
-ESW
L
X Ray
6
Spectrum Rays
7
Source of X Ray :
1. Artificial :
a. Radiology unit
b. Diode tube
c. Radio station
d. Radar macchine
2. Natural :
a. Cosmic
b. Earth
c. Radioactive material
8
Cathode Electron mA
KV
Anode
Heat 99%
X Ray 1%
9
X Ray :
1. Darkened film paper
2. Material penetrable
3. Unaffectable by lens or mirror
4. Ionated material and have biological effect
5. In the linier way
6. Same with light velocity
7. Fluorescensi & Fosforescensi
8. Effected by prisma
10
RADIOLOGY
1. GI tract:
- Oesphagus photo
- UGI Photo/ Ba intake
- Ba In loop/Ba enema
- Lopograf
- Appendicogram
3. URINARY TRACT
- IVU
- Infusion urogaf
- RPG
- Cystograf
- Urethrograf
- Urethro cystograf
- Voiding urethrocystograf
- Double pole voiding
urethrocystograf
4. Genetalia :
- Bulbograf
- HSG
5. Vascular :
- Arteriograf
- Aortograf
- Phlebograf
- Spleento Portograf
6. System Lymphe:
- Lymphograf
Histerosalpingogram
Pengaruh Radiasi pada:
1. Sel - Dinding sel
- Inti sel
- Protoplasma
2. Jaringan
3. Organ
Klinis :
1. Kelainan acute
2. Kelainan chronis
CT Scan
CT Scan
RADIO BIOLOGY
- Leukemia
- Thyroid tumors
- Breast tumors
- Lung tumors
- Skin tumors
The total dose required to
produce carcinogenesis
when multiple short
exposure are taken could
be about twice that
required to produce
carcinogenesis as a result
of a single dose
3 Natural Sources of
Radiation That are Un
Avoidable:
1. Cosmic radiation
2. Radiation on the
earth
3. Radon
Cathode Electron mA
KV
Anode
Heat 99%
X Ray 1%
35
5 Factors That Affect the
Patient Dose in
Radiography :
Ditunjukan kepada:
1. Penderita
2. Petugas Radiasi
3. Petugas yang jarang terkena
radiasi
4. Masyarakat umum
Exposure of the
Radiologist to
Radiations Is Controlled
by
Radioisotope
Gamma Camera
PET
SPECT
Used with the other diagnostic modality
50
ADVANTAGES
1. Diagnose Purpose to see :
a. Organ function : - ren
- hepar
- vascularisation
b. Anatomi/patologi disorder
2. Therapy
a. Tumor ablation therapy
b. Tumor metastase therapy
51
ADVANTAGES :
1. High sensititity
2. Can see organ function
DISADVANTAGES
1. Radiation dangerous
2. Low spesifitas
52
Figure 1.2 99mTc thyroid scan of a patient with toxic diffuse goitre (Graves
disease) showing diffusely increased uptake and visualization the pyramidal
lobe.
53
Figura 1.5 99mTc thyroid scan (a) showing a large multinodular goitre with
retrosternal extension in a patient with pressure symptoms and stridor who was
unsuitable for surgery. Following treatment with 400 MBq 131I the pressure
symptoms improved (b) and after 400 MBq (c) the goitre was notably smaller.
54
Figure 4.14 Neublastoma metastases. This case demonstrates mixed cold and hot
metastases of neuroblas. Cold photopenic lesion are present in the spine (a) and ribs
(b). Hypermetabolic lesion are present in the ribs and metaphyses of long bones (a).
55
BASIC RADIOTHERAPY AND
NURSING
RADIOLOGIC DEPARTMENT
Dr. SAIFUL ANWAR HOSPITAL MALANG
2013 56
RADIOTHERAPY
DEFINITION : THERAPY
- RAY-IONIZATION/PARTIKEL
RADIATION : - PASSES MATTER, INTERACT WITH
MATERIAL, TRANSFERRING SOME/ALL ENERGY TO THE
ATOM OF THE MATERIAL
RADIATION ATOM NETRAL ION
57
58
59
Indication
Benign tumor
Malignant tumor ( Sarcoma,Carsinoma)
Time : (depend on clinical patient)
- Elective Radiation
- Cito Radiation
- Urgent Radiation
60
RADIATION
A. PHOTON
- GAMMA RAY X RAY
B. PARTICLE :
SINAR ALPHA (+)
SINAR BETA (-)
ELEKTRON (-)
NEUTRON (+/-)
PROTON (+)
61
RADIOTHERAPY MACHINE
A. SOURCE
- NATURAL GAMMA
ATOM HALF LIFE
* COBALT 60 5 6 TAHUN
* CECIUM 23 30 TAHUN
* RADIUM 1500-1600 TAHUN
* IRIDIUM 72 HARI
- GENERATOR :
* LINIAC
* BETATRON
* CICLOTRON
B. ENERGY
1. GRANZ RAY THERAPY
2. CONTACT THERAPY
3. ORTHO VOLT :
- SUPERFICIAL
- DEEP VOLTAGE
62
ADVANTAGE MEGA VOLTAGE MACHINE
SHARP FIELD AREA
MINIMAL SCATTER RAY
MINIMAL SIDE EFFECT IN BONES AND TISSUE
HIGH PENETRA TE
RADIATION SOURCE :
CLOSE
OPEN
63
PROCEDURE OF RADIATION
A. RADIATION EXTERNAL:
1. TELETERAPI
2. BRACHYTERAPI
CARA : - INTRA CAVITER/INTRALUMINAR
- INTER STITIEL/IMPLANT
- CONTACT
TECHNIK :
- CONVENSIONAL
- AFTERLOADING
DEPEND ON DOSE:
- L D R > 8 JAM
- M D R APROX. 40 MENIT
-HDR MINUTES
B. INTERNAL RADIATION
- PER ORAL J 131
- PARENTERAL POSPOR
64
THE SUCCESFULL OF RADIATION
THERAPY DEPEND ON :
* CONTINUITY THERAPY
PATIENT CONDITION
PRECISE OF RADIATION AREA
STAGING
ETIOLOGY TUMOR (Ca,Sa)
65
TECHNICAL
RADIATION
1. STATIONARY : - 1 AREA
- 2 AREA PLAN PARALEL
TANGENSIAL
- MULTIPLE
2. ROTATION : - FULL
- PARTIAL
DOSE:
-1 RAD = 1 cGy
-100 RAD = 1 Gy
PURPOSE :
RADICAL CURATIVE
PHALIATIVE RELIEVING THE SYMPTOM OF
CANCER
66
Principles of radiobiology :
67
PREPARING IRRADIATION
A. STAFF ADMINISTRATION
- PREPARING EQUIPMENT
- EXPLAINED ABOUT RADIATION TO FAMILY AND PATIENT
- COST
- INFORMCONCENT
B. NURSE
- EXPLAINED PREREQUISE IRRADIATION
- EXPLAINED PROHIBITION
- EXPLAINED ACUT/CHRONIC SIDE EFFECTS
- EXPLAINED ADDED IRRADIATION IF NEEDFUL
68
C. PATIENT
1. GENERAL CONDITION, LAB.
2. SIDE EFFECTS
3. NURSE DURING IRRADIATION
- Radiation area forbid to contact with water
- if necessity mictie,defecation clean with minimal
water and perspire with soft and dry towel
- forbid to use zalep/cream
- radiation in Nasopharynx area :
* forbid to use denture
* no teeth caries
* Post pull out teeth > 2 minggu
* forbid eat hot food
* Gargling, to dry mouth
* Give anti fungi oral
* Dysphagia analgetica
69
- Radiation area of uterine :
* Radiation area forbid to contact of water
* Forbid coitus for 2 weeks post
radiation
4. Adviced :
* Consumtion of fruits, vegetable, milk good condition
* outpatient, better hospitalized
70
5. Follow up patient
a. durante radiation
- Check every 5 x radiation
check : - Hb
- Leucosit
- Thrombosit
- general condition, complaint or occur of side
effects
b. after radiation
- 2 weeks after radiation
- 1 month later
- 3 months later
- 6 months later and continue every 6 months
3 bulan post radiation ,check PA laboratory to evaluate the tumor
71
6. Side effect (+) :
Refer to :
- Surgery department
- Rehabilitation medicine
- Psychiatri
- Family
72
Irradiation performed :
PREOPERATION
POST OPERATIVE
DURANTE OPERATIVE
CITOSTATIKA (+)
* PRECHEMOTHERAPY
* CHEMOTHERAPY (+)
* POST CHEMO
IMUNOTHERAPY
SINGLE
73
CITO RADIASI
DEFINITION:
EXAMPLE:
- VENA CAVA SUPERIOR SYNDROME
- BLEEDING PROFUS
- HIGH SERUM CREATININ
74
URGENT RADIATION
DEFINITION :
EXAMPLE :
- METASTASE VERTEBRAE
- JOINT SPACE NARROWING
75
SIDE EFFECT IRRADIATION
1. ACUT INFLAMASI
TIME 6 8 WEEKS
- GENERAL:
* RADIATION SIKCNESS
* DEPRESSED OF HEMOPOITIC S
* NAUSE, HEAD ACHE DLL
- LOKAL :
* ERYTHEMA
* DISKUAMASI
* MUCOSITIS
* IRITATION
* DRY MOUTH
* DISURIA, DLL
76
2. CHRONIC : FIBROSIS IRREVERSIBLE
- TIME : > 8 WEEKS
- GENERAL :
* HEMATOLOGIC DISORDER
- LOCAL :
* PIGMENTATION
* ATROPHI
* TELEANGECTACIS
* ULCERASION
* FIBROSIS
* NECROSIS
77
DOSE OF IRRADIATION DEPEND ON :
KINDS OF TUMOR
PURPOSE (RADICAL/PHALIATIVE)
TOLERANCE OF AROUND TISSUE
STAGING
PRE/POST OP
RADIATION PROTECTION:
1. MACHINE SPECIAL PROTECTION (+)
2. BUILDING : - THICKNESS
- PLUMBUM LAYER
- SPECIAL GLASS
78
3. OPERATOR :
- APRON
- FILM BADGE
- AFTERLOADING
- HIGH CALORY ,HIGH PROTEIN
4. PASIENT
- BLOCK
- WHOLE ABDOMEN BLOCK HEPAR, REN
- WHOLE PELVIS BLOCK LIGAMENTUM INGUINALE
- NASOPHARYNX PLANPARALEL 4000 cGy
MEDULLA SPINALIS ,
BLOCK(+) ETC
79
PREREQUSED IRRADIATION :
Hb 10 gram %
LEUKO 3000 10.000
THROMBOSIT 100.000 AMBULATORY
> 80.000 HOSPITALIZED
80
81