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15 September 2022 | Story André Damons | Photo André Damons
Dr Osayande Evbuomwan, Prof Willy Vangu and Dr Gerrit Engelbrecht
Dr Osayande Evbuomwan, nuclear medicine specialist and Senior Lecturer, left, and Dr Gerrit Engelbrecht, Clinical Head of the Department of Nuclear Medicine at the UFS, right, with Prof Willy Vangu, Chief Specialist and Head of Nuclear Medicine at the University of the Witwatersrand, after his lecture.

There is no doubt that an institution like the University of the Free State (UFS), with its calibre and pedigree, needs a PET/CT machine (medical-imaging device that simultaneously and clearly reveals both anatomical details and metabolic processes within the body), particular in oncology, in improving the management of patients. 

This is according to Prof Willy Vangu, Chief Specialist and Head of Nuclear Medicine at the University of the Witwatersrand, who was a guest lecturer on 8 September 2022 at the Department of Nuclear Medicine at the UFS.

Positron emission tomography (PET) is a type of nuclear medicine imaging modality that measures the metabolic activity of the cells of body tissues. PET imaging is useful in the evaluation of patients with neurological, cardiac, infection, inflammation, and most importantly oncological conditions. Through its ability to detect metabolic changes very early, it can detect disease conditions that might not be easily detected on other forms of anatomical imaging.

Role of PET/CT in different clinical scenarios

In his lecture, Prof Vangu talked about the role of PET/CT in different clinical scenarios. By giving practical examples, he explained the role of PET/CT in different aspects of clinical medicine, including brain imaging for dementia, movement disorder and cerebrovascular reserve. 

“Looking at dementia, we will focus on one of diseases that is today becoming a major source of health concern, Alzheimer's disease. The latest Alzheimer's report that was published in 2018 stated that there are 50 million individuals currently suffering from Alzheimer's. They forecast that in 30 years we are going to have more than 150 million people suffering from this disease. PET/CT imaging can identify very early the typical patterns associated with all the different types of dementias, including Alzheimer's disease…”

For cardiac application, Prof Vangu said there are so many indications for PET/CT in cardiac imaging. One of the most important is the assessment of myocardial viability, in patients who have suffered from cardiomyopathy due to ischemic heart disease. PET/CT offers a noninvasive method of identifying viable myocardium that would benefit from revascularisation, with a very high diagnostic accuracy. 

Prof Vangu, who is also the head of nuclear medicine at the Charlotte Maxeke Johannesburg Academic and Chris Hani Baragwanath hospitals as well as head of the department for radiation sciences at the University of the Witwatersrand, said PET has been around for many years and is not something new. However, in clinical practice, PET imaging became significant with a breakthrough that occurred with the production of the glucose analogue tracer, 18F-fluorodeoxyglucose (FDG). This tracer in PET/CT imaging has revolutionised the management of cancer patients for the oncologist. It offers the ability of more accurate cancer staging, assessment of treatment response, assessment of disease recurrence and in some situations, surveillance. It has the ability to predict early which cancer patients will benefit from a particular drug, thereby giving the oncologist an idea on either to de-escalate treatment or change to a second line regimen very early on in the management. 

PET-CT scan imaging machine

An internet example of an image taken by a PET/CT machine. Photo for illustration: A PET/CT Imaging machine.


PET/CT came onto the market only in the year 2001, when it was launched for the first time by David Townsend (a physicist) and Ronald Nutt (electrical engineer). As at today, almost every institution in the country has at least one PET/CT machine.


“Looking at clinical applications, which is really the crux of the lecture today, there are so many clinical applications to talk about. You need a full week of a PET/CT symposium to go through all of them (and) maybe that might not even be enough. We can at least from this talk have an idea on how PET/CT can be applied in clinical medicine,” said Prof Vangu.

No other road for the university but to get a PET/CT machine

He also showed the impact and results that PET/CT imaging had in the management of infection and inflammation including TB. He said the role of PET/CT in TB is for monitoring of treatment, identification of extrapulmonary TB and prognosis. 

In concluding his lecture, he said there is no other road for the university but to get a PET/CT machine. “There is no argument about it. The institution needs it to improve the management of patients, especially the oncology and cardiology patients. Confidently making the decision on which patients to treat, how to treat them, identifying and evaluating their true response to therapy requires a PET/CT machine.

“I am happy to hear that the policy- and decisions-makers in the province and the university are looking forward to having a PET/CT machine,” he said later. 

Dr Osayande Evbuomwan, nuclear medicine specialist and Senior Lecturer, and Dr Gerrit Engelbrecht, Clinical Head of the Department of Nuclear Medicine at the UFS, are both looking forward of having a PET/CT in the department because in addition to its use in clinical setting, it has a huge role to play in research and training postgraduate students, as PET/CT imaging makes up a huge chunk of the postgraduate training curriculum

News Archive

Stress and fear on wild animals examined
2013-06-04

 

Dr Kate Nowak in the Soutpansberg Mountain
Photo: Supplied
04 June 2013

Have you ever wondered how our wild cousins deal with stress? Dr Kate Nowak, visiting postdoctoral researcher at the Zoology and Entomology Department at the UFS Qwaqwa Campus, has been assigned the task to find out. She is currently conducting research on the effects that stress and fear has on primate cognition.

The Primate and Predator project has been established over the last two years, following Dr Aliza le Roux’s (also at the Zoology and Entomology Department at Qwaqwa) interest in the effects of fear on primate cognition. Dr le Roux collaborates with Dr Russel Hill of Durham University (UK) at the Lajuma Research Centre in Limpopo and Dr Nowak has subsequently been brought in to conduct the study.

Research on humans and captive animals has indicated that stress can powerfully decrease individuals’ cognitive performance. Very little is known about the influence of stress and fear on the cognition of wild animals, though. Dr Nowak will examine the cognition of wild primates during actual risk posed by predators. This is known as the “landscape of fear” in her research.

“I feel very privileged to be living at Lajuma and on top of a mountain in the Soutpansberg Mountain Range. We are surrounded by nature – many different kinds of habitats including a tall mist-belt forest and a variety of wildlife which we see regularly, including samangos, chacma baboons and vervet monkeys, red duiker, rock hyrax, banded mongooses, crowned eagles, crested guinea fowl and cape batis. And of course those we don't see but find signs of, such as leopard, genet, civet and porcupine. Studying the behaviour of wild animals is a very special, and very humbling, experience, reminding us of the diversity of life of which humans are only a very small part,” said Dr Nowak.

At present, the research team is running Giving up Densities (GUD) experiments. This represents the process during which an animal forsakes a patch dense with food to forage at a different spot. The animal faces a trade-off between meeting energy demands and safety – making itself vulnerable to predators such as leopards and eagles. Dr le Roux said that, “researchers from the US and Europe are embracing cognitive ecology, revealing absolutely stunning facts about what animals can and can’t do. Hence, I don’t see why South Africans cannot do the same.”

Dr Nowak received the Claude Leon Fellowship for her project. Her research as a trustee of the foundation will increase the volume and quality of research output at the UFS and enhance the overall culture of research. Her analysis on the effect that stress and fear have on wild primates’ cognition will considerably inform the emerging field of cognitive ecology.

The field of cognitive ecology is relatively new. The term was coined in the 1990s by Les Real to bring together the fields of cognitive science and behavioural ecology.


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