KORELASI INTENSITAS SINYAL DWI DAN NILAI ADC DENGAN HASIL SITOLOGI PAP SMEAR UNTUK MENILAI HASIL TERAPI PADA PASIEN KANKER SERVIKS PASCATERAPI INTISARI

FERA NOVISARLITA, Prof. dr. Arif Faisal, Sp.Rad (K), DHSM.; dr. Hesti Gunarti, Sp.Rad (K)

2022 | Tesis-Spesialis | RADIOLOGI

Latar belakang : Diffusion-Weighted Imaging (DWI), Apparent diffusion coefficient (ADC), Pap smear untuk mengetahui hasil terapismear untuk mengetahui hasil terapi Tujuan penelitian : Mengetahui hubungan intensitas sinyal DWI, nilai ADC dengan hasil sitologi pap smear untuk menilai hasil terapi pasien kanker serviks pascaterapi. Bahan dan cara : Penelitian observasional analitik korelasi cross-sectional, subyek data sekunder, consecutive non-random sampling. Subyek penelitian hasil MRI pelvis 1,5T pascaterapi RSUP Dr. Sardjito Yogyakarta Maret 2017 - Februari 2022. Intensitas sinyal DWI non restricted, slight restricted, partial restricted, dan restricted, hasil terapi residu, residive, fibrosis, tak tampak residu/residive, sikatriks. Nilai ADC menggunakan ROI (Region of Interest) sekuens DWI, dikorelasikan dengan uji korelasi Spearman. Hasil pap smear tidak terdapat sel ganas, terdapat sel ganas, diskariotik. Hasil : Diperoleh 36 subyek penelitian, restricted 21 (58,3%), residu 21 (58,3%). Median ADC 1,25x10-3mm2/s, terendah 0,68x10-3mm2/s, tertinggi 2,23x10-3mm2/s, pap smear pascaterapi tidak terdapat sel ganas 27 subyek (75,0%). Hasil pap smear tidak terdapat sel ganas pada DWI non restricted (72,7%), slight restricted (100,0%), partial restricted (100,0%), restricted (71,4%). Korelasi p=0,614 tidak ada hubungan bermakna intensitas sinyal sekuen DWI dengan hasil pap smear, koefisien korelasi sangat lemah 0,087 (<0,2). Median ADC tertinggi subyek tidak ditemukan sel ganas 1,27 x10-3mm2/s, diskariotik 1,21 x10-3mm2/s, terendah pada terdapat sel ganas 1,17 x10-3mm2/s. Hasil Korelasi Spearman tidak terdapat korelasi yang bermakna nilai ADC dengan hasil pemeriksaan pap smear p=0,427 (p>0,05). Koefisien korelasi -0,137 (< 0,2). Koefisien negative semakin tinggi ADC semakin tidak terdapat sel ganas. Kesimpulan : Korelasi nilai p=0,614 tidak ada hubungan bermakna intensitas sinyal DWI dengan hasil pap smear, koefisien korelasi 0,087 (<0,2). Korelasi Spearman tidak terdapat korelasi yang bermakna nilai ADC dengan hasil pap smear p=0,427 (p>0,05). Koefisien korelasi -0,137 (< 0,2). Koefisien negative, semakin tinggi ADC semakin tidak terdapat sel ganas.

Background : Diffusion-Weighted Imaging (DWI), Apparent diffusion coefficient (ADC), Pap smear were used to assess the result of therapy Objective : Understanding the correlation between DWI signal intensity, ADC value with cytology pap smear to assess the result of therapy on post therapy uterine cervical carcinoma. Material and methods : A cross-sectional correlation analytic observational study,secondary data, consecutive non-random sampling. Subjects are pelvic MRI 1,5T post therapy at Dr. Sardjito Hospital March 2017-February 2022. DWI signal intensity non restricted, slight restricted, partial restricted, restricted, therapy result residual, residive, fibrotic, no residual/residive, cicatrix, pap smear with malignant cells, no malignanat cells, dyscariosis. ADC value was measured with ROI (Region of Interest) on DWI sequence, correlated with Spearman correlation test. Result : There were 36 subject, mean age 51,25 years, DWI restricted 21 (58,3%), residual 21 (58,3%), pap smear post therapy no malignant cells 27 (75,0%). Pap smear result no malignant cells on DWI non restricted (72,7%), slight restricted (100,0%), partial restricted (100,0%), restricted (71,4%). Correlation p=0,614, no significant correlation between DWI signal intensity with the pap smear, correlation coefficient 0,087 (<0,2). Highest median ADC value for no malignant cells 1,27 x10-3mm2/s, dyscariosis 1,21 x10-3mm2/s, the lowest was on malignant cells 1,17 x10-3mm2/s. No significant correlation between ADC value with pap smear p=0,427. Correlation coefficient -0,137 (< 0,2). The coefficient is negative, the higher ADC value the more possible there are no malignant cells. Conclusion : The correlation result p=0,614, which mean there is no significant correlation between DWI intensity with the pap smear, correlation coefficient 0,087 (<0,2). No significant correlation between ADC value with pap smear p=0,427, correlation coefficient -0,137 (< 0,2). The coefficient is negative, the higher ADC value the more possible no malignant cells.

Kata Kunci : Kanker serviks pasca terapi, intensitas sinyal DWI, nilai ADC, Post therapy uterine cervical cancer, DWI signal intensity, ADC value, pap smear