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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

Stem cell research and human cloning: legal and ethical focal points
2004-07-29

   

(Summary of the inaugural lecture of Prof Hennie Oosthuizen, from the Department of Criminal and Medical Law at the Faculty of Law of the University of the Free State.)

 

In the light of stem cell research, research on embryo’s and human cloning it will be fatal for legal advisors and researchers in South Africa to ignore the benefits that new bio-medical development, through research, contain for this country.

Legal advisors across the world have various views on stem cell research and human cloning. In the USA there is no legislation that regulates stem cell research but a number of States adopted legislation that approves stem cell research. The British Parlement gave permission for research on embryonic stem cells, but determined that it must be monitored closely and the European Union is of the opinion that it will open a door for race purification and commercial exploitation of human beings.

In South Africa the Bill on National Health makes provision for therapeutical and non therapeutical research. It also makes provision for therapeutical embryonical stem cell research on fetuses, which is not older than 14 days, as well as for therapeutical cloning under certain circumstances subject to the approval of the Minister. The Bill prohibits reproductive cloning.

Research on human embrio’s is a very controversial issue, here and in the rest of the world.

Researchers believe that the use of stem cell therapy could help to side-step the rejection of newly transplanted organs and tissue and if a bank for stem cell could be built, the shortage of organs for transplants would become something of the past. Stem cells could also be used for healing of Alzheimer’s, Parkinson’s and spinal injuries.

Sources from which stem cells are obtained could also lead to further ethical issues. Stem cells are harvested from mature human cells and embryonic stem cells. Another source to be utilised is to take egg cells from the ovaries of aborted fetuses. This will be morally unacceptable for those against abortions. Linking a financial incentive to that could become more of a controversial issue because the woman’s decision to abort could be influenced. The ideal would be to rather use human fetus tissue from spontaneous abortions or extra-uterine pregnancies than induced abortions.

The potential to obtain stem cells from the blood of the umbilical cord, bone-marrow and fetus tissue and for these cells to arrange themselves is known for quite some time. Blood from the umbilical cord contains many stem cells, which is the origin of the body’s immune and blood system. It is beneficial to bank the blood of a newborn baby’s umbilical cord. Through stem cell transplants the baby or another family member’s life could be saved from future illnesses such as anemia, leukemia and metabolic storing disabilities as well as certain generic immuno disabilities.

The possibility to withdraw stem cells from human embrio’s and to grow them is more useable because it has more treatment possibilities.

With the birth of Dolly the sheep, communities strongly expressed their concern about the possibility that a new cloning technique such as the replacement of the core of a cell will be used in human reproduction. Embryonic splitting and core replacement are two well known techniques that are associated with the cloning process.

I differentiate between reproductive cloning – to create a cloned human embryo with the aim to bring about a pregnancy of a child that is identical to another individual – and therapeutically cloning – to create a cloned human embryo for research purposes and for healing human illnesses.

Worldwide people are debating whether to proceed with therapeutical cloning. There are people for and against it. The biggest ethical objection against therapeutical cloning is the termination of the development of a potential human being.

Children born from cloning will differ from each other. Factors such as the uterus environment and the environment in which the child is growing up will play a role. Cloning create unique children that will grow up to be unique individuals, just like me and you that will develop into a person, just like you and me. If we understand this scientific fact, most arguments against human cloning will disappear.

Infertility can be treated through in vitro conception. This process does not work for everyone. For some cloning is a revolutionary treatment method because it is the only method that does not require patients to produce sperm and egg cells. The same arguments that were used against in vitro conception in the past are now being used against cloning. It is years later and in vitro cloning is generally applied and accepted by society. I am of the opinion that the same will happen with regard to human cloning.

There is an argument that cloning must be prohibited because it is unsafe. Distorted ideas in this regard were proven wrong. Are these distorted ideas justified to question the safety of cloning and the cloning process you may ask. The answer, according to me, is a definite no. Human cloning does have many advantages. That includes assistance with infertility, prevention of Down Syndrome and recovery from leukemia.

 

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