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Fulltext Perbandingan dos glandular purata payudara berdasarkan kombinasi anod/penuras tungsten/rhodium dan tungsten/argentum pada mamografi digital

Chelliah, Kanaga Kumari, Lumin, Felecia

Jurnal Sains Kesihatan Malaysia, 2012;10(1):53-56.
MyJurnal

Mamografi adalah cara paling efektif untuk mengesan keabnormalan payudara di kalangan wanita. Namun, mamografi dipercayai boleh menyebabkan karsinogenesis aruhan sinaran. Justeru pengukuran dos adalah penting untuk menganggar risiko dan mengawal kualiti imej. Kajian ini dijalankan untuk membandingkan dos glandular purata (AGD) yang diperolehi fantom payudara berdasarkan dua kombinasi anod/penuras yang berbeza iaitu tungsten/rhodium (W/Rh) dan tungsten/argentum (W/Ag). Fantom payudara CIRS 012A didedahkan pada projeksi kraniokaudal (CC) menggunakan sistem mamografi digital Hologic Selenia. Kerma udara kemasukan permukaan (ESAK) diukur menggunakan dosimeter pendar cahaya terma (TLD). AGD diperolehi daripada pengiraan asas ESAK dengan faktor penukaran berdasarkan formula Euref. Ujian t tak bersandar menunjukkan perbezaan bererti dalam purata AGD yang diperolehi. Purata AGD W/Rh adalah lebih tinggi berbanding purata AGD W/Ag (p = 0.002, 95% CI: 0.22, 0.53). Kesimpulannya, penggunaan W/Ag menyumbang kepada pengurangan dos semasa pemeriksaan mamografi.
Perception regarding interprofessional learning among health sciences undergraduates in Universiti Kebangsaan Malaysia. [Persepsi terhadap pembelajaran interprofesion di kalangan pelajar prasiswazah sains kesihatan Universiti Kebangsaan Malaysia]

Syafiqah Ismail, Chelliah, Kanaga Kumari, Nabishah Mohamad, Benny Efendie

Jurnal Sains Kesihatan Malaysia, 2013;11(2):29-34.
MyJurnal

Interprofesion learning (IPL) occurs when students from two or more different professionals study with and learn about different professions. IPL is believed to enhance the collaboration level within the different profession after graduated. The objective of this research is to compare perception levels among the respondents coming from eleven different professions including Medical, Nursing, Dentistry, Pharmacy, Occupational Therapy, Dietetics, Audiology, Speech Science, Physiotherapy, Optometry and Diagnostic Imaging & Radiotherapy. Each respondent were selected randomly representing each year of study for each profession. They were required to fill up the survey form provided. 330 survey forms were returned instead of 367 distributed copies or 90% from overall surveys. Using one-way ANOVA analysis, all professions indicate same level of perception in knowledge subscale (p = 0.11), the practice of teamwork and cooperation (p = 0.23) and various methods to start the IPL (p = 0.61). However, for professional identity scales and interprofession educational preparation the value was (p < 0.05). Post-hoc Turkey test, indicated Physiotherapy students had a higher average score (M = 4.35 ± 0.54) compared to Speech Science (M = 3.75 ± 0.59) in professional identity subscale whereas in students preparation subscale for interprofession education, only Physiotherapy students had higher score (M = 4.15 ± 0.82) in comparison to Diagnostic Imaging & Radiotherapy (M = 3.25 ± 0.83). Besides, independent T test showed the students were in favour of having IPL in early year of education with the average score (M = 3.53 ± 1.029) for year one and year two compared to year three to five (M = 3.34 ± 1.089). The result form this research shows that the students have a positive perception towards IPL based on the average values not more than 3.0.
Keywords: Interprofesional learning; Student’s perception; Profession; Collaboration
Fulltext Perbandingan dos sinaran antara prosedur urografi intravena (IVU) dan tomografi berkomputer helikal tanpa kontras (UHCT) urograf

Akmal Sabarudin, Chelliah, Kanaga Kumari, Hamzaini Abdul Hamid

Jurnal Sains Kesihatan Malaysia, 2014;12(2):9-16.
MyJurnal

Urografi intravena (IVU) dan tomografi berkomputer helikal tanpa kontras (UHCT) urografi adalah dua prosedur utama yang akan dijalankan semasa penyiasatan radiologi bagi pengesanan urolitiasis (batu karang) pada sistem genitourinari. Dedahan terhadap sinaran radiasi merupakan faktor kebimbangan utama dalam kedua-dua prosedur. Oleh itu, satu kajian perbandingan dos sinaran telah dijalankan antara prosedur IVU dan UHCT urografi di samping menentukan faktor dedahan optimum bagi kedua-dua prosedur tersebut. Kajian ini telah dijalankan ke atas fantom antropomorfik seluruh tubuh mengikut protokol sebenar bagi prosedur UHCT urografi dan penghasilan radiografi bersiri berserta dengan pemberian media berkontras bagi prosedur IVU. Sebanyak tiga parameter dedahan voltan tiub digunakan iaitu 75 kVp, 80 kVp dan 85 kVp bagi prosedur IVU dan 100 kVp, 120 kVp dan 140 kVp bagi prosedur UHCT urografi . Hasil dos sinaran bagi prosedur IVU yang diperolehi adalah 1.40 mSv, 2.10 mSv dan 2.79 mSv bagi 75 kVp, 80 kVp dan 85 kVp. Manakala bagi prosedur UHCT urografi , sebanyak 0.76 mSv, 1.32 mSv dan 1.82 mSv dos sinaran direkodkan bagi 100 kVp, 120 kVp dan 140 kVp. Hasil kualiti imej optimum adalah menggunakan dedahan sebanyak 85 kVp bagi prosedur IVU dan 120 kVp bagi prosedur UHCT urografi . Kesimpulannya, walaupun tidak terdapat perbezaan signifi kan, dos sinaran yang terhasil daripada prosedur IVU adalah kekal lebih tinggi daripada prosedur UHCT urografi .
Breast imaging using electrical impedance tomography: correlation of quantitative assessment with visual interpretation

Zain NM, Chelliah KK

Asian Pac J Cancer Prev, 2014;15(3):1327-31.
PMID: 24606460

BACKGROUND: Electrical impedance tomography (EIT) is a new non-invasive, mobile screening method which does not use ionizing radiation to the human breast; allows conducting quantitative assessment of the images besides the visual interpretation. The aim of this study was to correlate the quantitative assessment and visual interpretation of breast electrical impedance tomographs and associated factors.
MATERIALS AND METHODS: One hundred and fifty mammography patients above 40 years and undergoing EIT were chosen using convenient sampling. Visual interpretation of the images was carried out by a radiologist with minimum of three years experience using the breast imaging - electrical impedance (BI-EIM) classification for detection of abnormalities. A set of thirty blinded EIT images were reinterpreted to determine the intra-rater reliability using kappa. Quantitative assessment was by comparison of the breast average electric conductivity with the norm and correlations with visual interpretation of the images were determined using Chi-square. One-way ANOVA was used to compare the mean electrical conductivity between groups and t-test was used for comparisons with pre-existing Caucasians statistics. Independent t-tests were applied to compare the mean electrical conductivity of women with factors like exogenous hormone use and family history of breast cancer.
RESULTS: The mean electrical conductivity of Malaysian women was significantly lower than that of Caucasians (p<0.05). Quantitative assessment of electrical impedance tomography was significantly related with visual interpretation of images of the breast (p<0.05).
CONCLUSIONS: Quantitative assessment of electrical impedance tomography images was significantly related with visual interpretation.
Fulltext Image quality of two full field digital mammography using a female breast phantom

Chelliah, Kanaga Kumari, Ang, Wee Chin, Abd Aziz Tajuddin, Arasaratnam, Shantini A., Suraya Aziz, Laila Suryani Elias

Jurnal Sains Kesihatan Malaysia, 2009;7(1):65-72.
MyJurnal

Digital mammography has been progressively introduced in screening centers and the concern is to achieve an image of diagnostic value which would be able to detect early changes in the breast tissue. The aim of this study was to evaluate the image quality of mammograms using quantitative and qualitative methods of two FFDM systems with variations in breast thickness and anode/filter combination. This study was done from January to April 2008 with two FFDM systems; Siemens Mammomat NovationDR at Diagnostic Imaging Department, Hospital Kuala Lumpur and Hologic Lorad Selenia at Breast Clinic, National Cancer Society. A CIRS012A tissue equivalent breast phantom (4, 5 and 6 cm) thickness was used to obtain images in the craniocaudal plane with 26-32 kVp and a combination of molybdenum/molybdenum (Mo/Mo) and molybdenum/rhodium (Mo/Rh) anode/filter. For the qualitative evaluation, two independent radiologist with a minimum of five years experience was used to score the images. Wilcoxon Sign Rank Test showed that there are no significant differences (p > 0.05) in image quality between both the FFDM systems. Kappa analysis had a poor agreement between the scores given by the two radiologists. The quantitative analysis using Mann-Whitney test showed that there are significant differences (p < 0.05) between the SNR values of both FFDM systems. Although the qualitative evaluation was similar, the study showed that Lorad Selenia had a significantly superior SNR value, hence would be a better tool to detect early changes in the breast tissue. This study also demonstrated that a lower kVp is more suitable with molybdenum filter and as the breast thickness is increased rhodium filter with higher kVp displayed better quality images.
Fulltext Is there an influence of dietary habits on breast density as seen on digital mammograms?

Voon NS, Chelliah KK

Asian Pac J Cancer Prev, 2011;12(8):1969-72.
PMID: 22292635

The purpose of this study was to evaluate the influence of dietary habit on breast density, which is an important risk factor for breast cancer. This cross-sectional study was performed on 64 Malaysian women of all races between the age of 35 to 70 years. All subjects underwent mammography and the breast density was analyzed from the images using BI-RADS by two independent radiologists. A validated food-frequency questionnaire was used to evaluate the nutrient intake. The data were analyzed using Chi-square test to evaluate the association of dietary habits to breast density. Based on the results, mutton, pork, vegetables, sweets, snacks, soy bean and eggs intake showed associations with increased breast density (p < 0.05) while grains, meat, beverages, oil and fruits, did not show any association (p > 0.05). As a conclusion, this study showed diet may make changes to the breast density as a risk factor for breast cancer.
Fulltext Bone mineral density and breast cancer risk factors among premenopausal and postmenopausal women: A systematic review

Zain NM, Seriramulu VP, Chelliah KK

Asian Pac J Cancer Prev, 2016;17(7):3229-34.
PMID: 27509955

BACKGROUND: Bone mineral density (BMD) is a lifetime marker of estrogen in a woman's body and has been associated with increased breast cancer risk. Nonetheless the actual association is still debatable. Furthermore, estrogen is very crucial in maintaining human bone density and gradually decreases over age. A systematic search was conducted to assess any association of BMD with breast cancer risk factors among premenopausal and postmenopausal women.

MATERIALS AND METHODS: Review identification was performed through databases searching on MEDLINE, CINAHL and SCOPUS and 19 qualified studies were elected. The keywords used were "bone mineral density", "breast cancer", and "breast density".

RESULTS: A total of 19 articles showed variation with the majority of the studies focused on postmenopausal and a few focused on premenopausal women. Overall there was no concensus on effects.

CONCLUSIONS: An enormous effort is being undertaken by researchers to prove that BMD might be one of the significant risk factors for breast cancer.
A comparative study of computed radiography-based mammography using digital phosphor storage plate and full field digital mammography

Chelliah KK, Tamanang S, Bt Elias LS, Ying KY

Indian J Med Sci, 2013 11 2;67(1-2):23-8.
PMID: 24178338

BACKGROUND: Two digital mammography systems, based on different physical concepts, have been introduced in the last few years namely the full-field digital mammography (FFDM) system and computed radiography-based mammography using digital storage phosphor plate (DSPM).
AIMS: The objective of this study was to compare the image quality for DSPM and FFDM using a grading scale based on previously published articles.
MATERIALS AND METHODS: This comparative diagnostic study was done for 5-month duration at the Breast Clinic. The system used was the Lorad Selenia FFDM system and the Mammomat 3000 Nova DSPM system. The craniocaudal and mediolateral oblique projections were done on both breast on 58 asymptomatic women using both DSPM and FFDM. The mammograms were evaluated for eight criteria of image quality: Tissue coverage, compression, exposure, contrast, resolution, noise, artifact, and sharpness by two independent radiologists.
STATISTICAL ANALYSIS: Wilcoxon Signed Rank Test and Weighted Kappa.
RESULTS: FFDM was rated significantly better (P < 0.05) for five aspects: Tissue coverage, compression, contrast, exposure, and resolution and equal to DSPM for sharpness, noise, and artifact.
CONCLUSION: FFDM was superior in five aspects and equal to DSPM for three aspects of image quality.
Validation of electrical impedance tomography qualitative and quantitative values and comparison of the numeric pain distress score against mammography

Juliana N, Shahar S, Chelliah KK, Ghazali AR, Osman F, Sahar MA

Asian Pac J Cancer Prev, 2014;15(14):5759-65.
PMID: 25081698

Electrical impedance tomography (EIT) is a potential supplement for mammogram screening. This study aimed to evaluate and feasibility of EIT as opposed to mammography and to determine pain perception with both imaging methods. Women undergoing screening mammography at the Radiology Department of National University of Malaysia Medical Centre were randomly selected for EIT imaging. All women were requested to give a pain score after each imaging session. Two independent raters were chosen to define the image findings of EIT. A total of 164 women in the age range from 40 to 65-year-old participated and were divided into two groups; normal and abnormal. EIT sensitivity and specificity for rater 1 were 69.4% and 63.3, whereas for rater 2 they were 55.3% and 57.0% respectively. The reliability for each rater ranged between good to very good (p<0.05). Quantitative values of EIT showed there were significant differences in all values between groups (ANCOVA, p<0.05). Interestingly, EIT scored a median pain score of 1.51±0.75 whereas mammography scored 4.15±0.87 (Mann Whitney U test, p<0.05). From these quantitative values, EIT has the potential as a health discriminating index. Its ability to replace image findings from mammography needs further investigation.
Fulltext Multimodality imaging in the assessment of thoraco-omphalopagus conjoined twin: lessons to learn

Chelliah KK, Faizah MZ, Dayang AA, Bilkis AA, Shareena I, Mazli M

Case Rep Radiol, 2012;2012:564036.
PMID: 22792503 DOI: 10.1155/2012/564036

Conjoined twins are rare and present a unique challenge to pediatric surgeons and radiologists. An imaging strategy to accurately define anatomic fusion, vascular anomalies, and other associated abnormalities is important for surgical planning and prognostic information. A conjoined female twin with a combined weight of 2.8 kg was born by emergency caeserean. Hence, a computed tomography scan of the thorax and entire abdomen at 1.25 mm slice thickness was performed to delineate the internal structures of the twins. CT-angiography defined specific vascular supply which determined the distribution of shared structures between the twins. An echocardiogram showed four heart chambers with atrioventricular septal defect. To further evaluate the heart chambers, the twin was planned for gated cardiac magnetic resonance imaging. Unfortunately, they succumbed 6 hours apart due to complication of septicemia. Magnetic resonance imaging and CT scan provide excellent anatomic detail, demonstrating organ position, shared viscera, and limited vascular anatomy, whilst angiography defined specific vascular supply, useful in determining the distribution of shared structures between the twins in planning for surgery.