{"id":20725,"date":"2026-07-20T09:41:43","date_gmt":"2026-07-20T02:41:43","guid":{"rendered":"https:\/\/fkg.ugm.ac.id\/?p=20725"},"modified":"2026-07-20T09:41:45","modified_gmt":"2026-07-20T02:41:45","slug":"membaca-bayangan-kanker-lima-modalitas-imejing-yang-bisa-menentukan-hidup-mati-pasien","status":"publish","type":"post","link":"https:\/\/fkg.ugm.ac.id\/en\/membaca-bayangan-kanker-lima-modalitas-imejing-yang-bisa-menentukan-hidup-mati-pasien\/","title":{"rendered":"Reading the Shadows of Cancer: Five Imaging Modalities That Can Determine Patient Survival"},"content":{"rendered":"<p class=\"wp-block-paragraph\"><strong>Half of patients with oral cancer worldwide will not survive beyond five years after diagnosis. Not necessarily because the cancer cannot be treated, but because by the time it is finally detected, the malignant cells have often already spread extensively. This is where diagnostic imaging can become a decisive factor.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph translation-block\">Dr. drg. Rini Widyaningrum, M.Biotech, from the Department of Dentomaxillofacial Radiology, Faculty of Dentistry, UGM, together with an interdisciplinary team from the Faculty of Medicine and the Faculty of Mathematics and Natural Sciences at UGM, published a comprehensive scientific review in the Indonesian Dentistry Magazine (Vol. 4, No. 1, April 2018). The review discusses the principles of interpreting oral cancer using five major imaging modalities: conventional radiography, CT, CBCT, MRI, and ultrasonography (USG). The message is serious: dentists who do not understand how to interpret these images may be missing a narrow window of opportunity to save a patient's life.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>When Cancer Hides Behind White and Black Shadows<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Oral cancer is not a rare disease. In Indonesia, it accounts for 3\u20134% of all cancer cases. Approximately 84\u201397% of these cases are squamous cell carcinoma (SCC), which develops from mutations in keratinocytes in the deepest layer of the oral mucosal epithelium. The problem is that these lesions are almost always asymptomatic in their early stages. Patients often seek medical attention only when the tumor has become large, painful, or cosmetically noticeable.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Conventional radiography, particularly panoramic radiography, remains an initial examination tool in Indonesia because it is relatively affordable and widely available. However, this modality has important limitations: it reduces three-dimensional structures to a two-dimensional image, is susceptible to superimposition, and cannot adequately visualize soft tissue.<\/p>\n\n\n\n<p class=\"wp-block-paragraph translation-block\">On radiographs, the most basic way to distinguish benign from malignant lesions is to examine the lesion margins. Well-defined lesions tend to be benign. In contrast, poorly defined margins with invasion into healthy trabecular bone in a finger-like or bay-type pattern raise suspicion of malignancy. Osteosarcoma may even exhibit characteristic sunburst or hair-on-end appearances, in which thin bony spicules project outward like the quills of a hedgehog in the area affected by the tumor.<\/p>\n\n\n\n<p class=\"wp-block-paragraph translation-block\">CBCT technology provides something of a middle ground. It offers three-dimensional imaging with lower radiation exposure than conventional CT, and its ability to visualize soft-tissue tumors has been reported as comparable to CT, MRI, and even bone scintigraphy. However, CBCT cannot be used to adequately evaluate metastases in the cervical lymph nodes, which is a critical limitation.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Five Millimeters That Can Change Prognosis<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">MRI and contrast-enhanced CT (CECT) are two of the most frequently used modalities for staging head and neck cancer and planning treatment. Both can visualize soft tissue, detect vascular infiltration, and identify lymph node metastases.<\/p>\n\n\n\n<p class=\"wp-block-paragraph translation-block\">On MRI, pathological tissue generally appears hypointense on T1-weighted sequences, due to its higher water content compared with healthy tissue, and hyperintense on T2-weighted sequences. For tongue cancer, MRI can measure tumor thickness, an important prognostic factor.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Research has shown that tongue tumor thickness is directly associated with the risk of cervical lymph node metastasis and recurrence. Tumors less than 3 mm thick have a low recurrence incidence and relatively favorable outcomes. However, tumors thicker than 9 mm have a recurrence probability of 24%, while the five-year survival rate in such cases is only 66%.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em>\u201cAccurate diagnosis determines the most effective type of treatment for patients, which can subsequently improve their prognosis and survival rate.\u201d \u2014 Dr. drg. Rini Widyaningrum, M.Biotech, et al., Majalah Kedokteran Gigi Indonesia, 2018<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">CT has its own advantages: it is highly sensitive for detecting cancer invasion into cortical bone because bone erosion or discontinuity of the cortical margins can be visualized clearly. MRI, by contrast, is superior for evaluating bone marrow invasion and detecting perineural involvement, two features that CT cannot visualize as effectively.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Ultrasound: An Affordable Modality That Remains Underused<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Among all the modalities discussed, ultrasound may be the most underutilized in Indonesia. Yet it offers several advantages that are difficult to overlook: it does not produce ionizing radiation, is relatively affordable, is not affected by metal artifacts from dental restorations, and can be performed repeatedly without adverse effects.<\/p>\n\n\n\n<p class=\"wp-block-paragraph translation-block\">On sonograms, cancers of the tongue and buccal mucosa appear hypoechoic (dark), whereas ameloblastomas of the jaw appear hyperechoic (bright). Intraoral ultrasound can even measure tongue tumor thickness using a linear probe with a frequency of 7\u201318 MHz, providing information comparable to MRI for this parameter.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For detecting cervical lymph node metastases, ultrasound has demonstrated a sensitivity of 86% and specificity of 73% compared with histopathological findings. Moreover, combining ultrasound with CT has been shown to provide the best results for evaluating lymph node metastases. Nevertheless, very few dental radiologists in Indonesia are currently skilled in using ultrasound to assess oral diseases.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>An Incomplete Roadmap<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">No single imaging modality is perfect for every condition. Conventional radiography and CBCT are suitable as affordable initial examinations but are insufficient for large tumors or lymph node metastasis assessment. CT excels in evaluating hard tissues and offers rapid image acquisition. MRI is superior for soft-tissue evaluation and does not use ionizing radiation. Ultrasound is ideal for initial screening and measuring tumor thickness, without any radiation exposure.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Staging using the TNM system, which classifies tumor size (T), lymph node involvement (N), and distant metastasis (M), serves as the basis for determining treatment. Stage I and II cancers can generally be managed with surgery or radiotherapy. Stages III and IV require combinations of surgery, radiotherapy, and chemotherapy.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The concerning reality is that most patients with oral cancer in Indonesia present at an advanced stage. This means that the critical window for single-modality treatment has already passed. Early detection, which depends heavily on dentists' ability to interpret imaging, is the key to changing this grim statistic.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Every radiograph interpreted by a dentist, every unusual white spot in the jawbone, and every poorly defined lesion margin on a panoramic image could be the starting point for saving someone from these troubling statistics.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Source DOI: <a href=\"http:\/\/doi.org\/10.22146\/majkedgiind.22050\">DOI: http:\/\/doi.org\/10.22146\/majkedgiind.22050<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Authors: Anny Anggraini; drg. Achmad Zam Zam Aghasy, M.Kes.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Photo: Pexels <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>","protected":false},"excerpt":{"rendered":"<p>Separuh dari penderita kanker mulut di seluruh dunia tidak akan bertahan melewati lima tahun sejak diagnosis. Bukan karena kankernya tak bisa diobati, melainkan karena ketika akhirnya terdeteksi, sel-sel ganas itu sudah terlanjur menyebar jauh. Di sinilah imejing diagnostik masuk sebagai penentu nasib. Dr. drg. Rini Widyaningrum, M.Biotech, dari Departemen Radiologi Dentomaksilofasial FKG UGM, bersama tim [&hellip;]<\/p>\n","protected":false},"author":615,"featured_media":20726,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[359,136],"tags":[298,307,289,291,297],"class_list":["post-20725","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-artikel","category-berita-terbaru","tag-sdg-10-mengurangi-ketidaksetaraan","tag-sdg-17-kemitraan-untuk-mencapai-tujuan","tag-sdg-3-kesehatan-dan-kesejahteraan-yang-baik","tag-sdg-4-pendidikan-berkualitas","tag-sdg-9-industri-inovasi-dan-infrastruktur"],"gutentor_comment":0,"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Membaca Bayangan Kanker: Lima Modalitas Imejing yang Bisa Menentukan Hidup Mati Pasien - Fakultas Kedokteran Gigi<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/fkg.ugm.ac.id\/en\/membaca-bayangan-kanker-lima-modalitas-imejing-yang-bisa-menentukan-hidup-mati-pasien\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Membaca Bayangan Kanker: Lima Modalitas Imejing yang Bisa Menentukan Hidup Mati Pasien - Fakultas Kedokteran Gigi\" \/>\n<meta property=\"og:description\" content=\"Separuh dari penderita kanker mulut di seluruh dunia tidak akan bertahan melewati lima tahun sejak diagnosis. Bukan karena kankernya tak bisa diobati, melainkan karena ketika akhirnya terdeteksi, sel-sel ganas itu sudah terlanjur menyebar jauh. Di sinilah imejing diagnostik masuk sebagai penentu nasib. Dr. drg. 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