Tesis

Titik Potong Nilai Minimal Apparent Diffusion Coefficient (ADC) Komponen Solid Tumor Ovarium Epitelial Borderline dan Ganas = Cut off Minimal Apparent Diffusion Coefficient (ADC) Value of Solid Component Borderline Epithelial Ovarian Tumor and Malignant Epitelial Ovarian Tumor.

Latar Belakang: Tumor ovarium merupakan tumor organ reproduksi yang menempati urutan terbanyak kedua penyebab kematian perempuan. Sembilan puluh persen tumor ovarium adalah jenis epitelial. Hingga saat ini belum ada pemeriksaan pre-operasi yang dapat membedakan tumor ovarium epitelial tipe borderline dengan ganas yang dapat membantu dalam menentukan strategi operasi. Tujuan: mengetahui kemampuan sequence Apparent Diffusion Coefficient (ADC) dalam membedakan tumor ovarium epitelial tipe borderline dan ganas. Metode: Penelitian ini menggunakan desain potong lintang. Dua puluh satu sampel tumor ovarium, 11 dengan hasil histopatologis tumor ovarium epitelial ganas dan 10 dengan hasil histopatologis tumor ovarium epitelial borderline, menjalani pemeriksaan Magnetic Resonance Imaging (MRI) dan dilakukan pengukuran nilai ADC minimal komponen padat tumor dengan menggunakan teknik free-hand. Hasil nilai ADC minimal masing-masing kelompok tumor ditentukan titik potongnya dengan menggunakan kurva receiver-operating characteristic (ROC). Hasil: Nilai median ADC tumor ovarium epitelial borderline 0,79 × 10 –3 2 mm /s dan tumor ovarium epitelial ganas 0,27 × 10 –3 2 mm /s. Titik potong nilai ADC dalam membedakan tumor ovarium epitelial borderline dan ganas yaitu 0,626 × 10 –3 2 mm /s, dengan perkiraan sensitivitas 80% dan spesifisitas 100%. Kesimpulan: Nilai ADC dapat meningkatkan peran MRI untuk membedakan tumor ovarium epitelial borderline dengan ganas supaya pasien dengan tumor ovarium epitelial bisa mendapatkan tatalaksana yang tepat dan adekuat.
Kata Kunci: Tumor ovarium epitelial, MRI, ADC


Background: Ovarian tumor are the second most common cause of death from gynecologic cancer in women. About 90% ovarian tumor is epithelial type. Until now, there is no pre-operative examination that was able to differentiate between borderline and malignant ovarian epithelial tumor, which is crucial for possible surgical strategies. Purpose: To determine the usefulness of Apparent Diffusion Coefficient (ADC) for differentiate between borderline and malignant ovarian epithelial tumor. Methods: This study used a cross sectional design. Twenty-one sample ovarian tumor, 11 were malignant and 10 were borderline, underwent Magnetic Resonance Imaging (MRI) examination, minimal ADC value was measured with free-hand technic. The receiver-operating characteristic (ROC) is perform to determine cut off of the minimal ADC value. Result: Mean of ADC value borderline ovarian epitelial tumor 0,79 × 10 –3 2 mm /s; malignant ovarian epitelial tumor 0,27 × 10 –3 2 mm /s. The ROC curve shows the cut off –3 point at 0,626 × 10 2 mm /s yielded 80% sensitivity and 100% specificity. Conclutions: ADC value measurement are able to improve the ability of MRI for differentiating between borderline and malignant ovarian epitelial tumor that crucial for surgical strategies.
Key words:Epithelial ovarian tumor, MRI, ADC