Diving Deeper: Adoption of Dual Energy CT Revolutionize Oncology TreatmentGetting upclose and personal with Radiation Oncology Unit at Songklanagrind Hospital Thailand


Songklanagarind Hospital is a leading healthcare institution in Hat Yai, Thailand, affiliated with Prince of Songkla University which has a rich history dating back to 1976.

Prince of Songkla University has a clear vision of becoming an exemplary medical center in Thailand. Its key missions include producing skilled medical specialists, conducting internationally recognized research, delivering professional medical services, and fostering positive working environment.

Today Songklanagarind Hospital is a vital learning and research hub, offering multidisciplinary tertiary medical care with an extensive range of services that cover both general medical practice as well as specializations such as pediatric oncology.  

Songklanagarind Hospital stands as a testament to a legacy of excellence, combining compassionate patient care with a dedication to advancing medical science in the country.

Since its establishment in 1982, the Radiation Oncology Unit at Songklanagarind Hospital (PSURO) has been at the forefront of oncological advancements, particularly in the treatment of head and neck cancer. The integration of dual-energy CT (Computed Tomography) simulation into their treatment protocols represents a significant leap forward in the unit's ability to provide state-of-the-art care. This innovative technology allows for more precise imaging, enhancing tumor delineation and improving the accuracy of radiation therapy planning. 

Dual-energy CT simulation distinguishes itself by using two different X-ray energy levels to create images, offering superior soft tissue contrast compared to traditional CT scans. This capability is crucial in the complex anatomy of the head and neck region, where distinguishing between tumor tissue and normal tissue is paramount for effective treatment. The commitment of PSURO to adopting such cutting-edge technologies underscores their dedication not only to advancing cancer treatment but also to ensuring that patients receive the most sophisticated and effective care available. This approach reflects the hospital's broader commitment to excellence in healthcare, emphasizing the importance of technological innovation in enhancing patient outcomes in oncology.

Dual-energy CT simulation is a sophisticated imaging technique that uses two different X-ray energy levels. This offers the possibility to acquire two consecutive spiral data sets at different energies and two different kV levels with independent mAs modulation to create more detailed and informative images of the human anatomy. This is especially relevant when distinguishing between different types of tissues, identifying contrast agents, or characterizing specific lesions. This technology offers several advantages over traditional single-energy CT scans, especially in the context of cancer treatment planning. For head and neck cancer patients, these advantages include improved tumor delineation, enhanced soft tissue contrast, and better identification of the tumor's extent and involvement with adjacent structures. Such precision is crucial for effective radiation therapy planning, as it allows for the accurate targeting of malignant tissues while minimizing exposure to healthy tissues.

In radiation oncology, the goal is to deliver a precise dose of radiation to the cancerous cells, reducing the tumor size or eliminating it altogether, while sparing the surrounding healthy tissue from unnecessary radiation. The dual-energy CT simulation at Songklanagarind Hospital enables radiation oncologists to create more personalized and effective radiation treatment plans. By distinguishing between different types of tissues more clearly, doctors can tailor the radiation beams to conform to the shape of the tumor. The implementation of dual-energy CT simulation in the Radiation Oncology Unit signifies a leap forward in the hospital's capabilities to fight head and neck cancer.

CT Sim Room for women and children at Radiation Oncology Unit at Songklanagarind Hospital, Thailand

CT Sim Room for women and children at Radiation Oncology Unit at Songklanagarind Hospital.
Image Courtesy from Radiation Oncology Unit at Songklanagarind Hospital

In 2023, PSURO team installed a dedicated CT simulation for women and children with cancer. This is a significant milestone in addressing healthcare equity as it targets the unique needs of these patient groups, ensuring that they have access to advanced cancer treatment technologies This move not only highlights the unit's commitment to precision and effectiveness in cancer care but also underscores a broader commitment to overcoming disparities within the healthcare system This sets a precedent for inclusivity and equity in healthcare, demonstrating that advanced medical treatments should be accessible to all, regardless of age or gender.

Dr. Thanarpan Peerawong

The center adopted CARE kV for children which is an automated technique that adjusts the tube voltage (kV) during a CT scan based on the patient's size and the region of the body being scanned. This optimization helps to reduce radiation dose while maintaining image quality, which is particularly beneficial for pediatric patients who are more sensitive to radiation exposure. For example, dedicated pediatric protocols automatically set a low tube voltage – in most cases at 70 kV. By customizing the radiation dose to each patient, Care kV aims to enhance patient safety and reduce unnecessary radiation exposure without compromising diagnostic image quality.