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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

The failure of the law
2004-06-04

 

Written by Lacea Loader

- Call for the protection of consumers’ and tax payers rights against corporate companies

An expert in commercial law has called for reforms to the Companies Act to protect the rights of consumers and investors.

“Consumers and tax payers are lulled into thinking the law protects them when it definitely does not,” said Prof Dines Gihwala this week during his inaugural lecture at the University of the Free State’s (UFS).

Prof Gihwala, vice-chairperson of the UFS Council, was inaugurated as extraordinary professor in commercial law at the UFS’s Faculty of Law.

He said that consumers, tax payers and shareholders think they can look to the law for an effective curb on the enormous power for ill that big business wields.

“Once the public is involved, the activities of big business must be controlled and regulated. It is the responsibility of the law to oversee and supervise such control and regulation,” said Prof Gihwala.

He said that, when undesirable consequences occur despite laws enacted specifically to prevent such results, it must be fair to suggest that the law has failed.

“The actual perpetrators of the undesirable behaviour seldom pay for it in any sense, not even when criminal conduct is involved. If directors of companies are criminally charged and convicted, the penalty is invariably a fine imposed on the company. So, ironically, it is the money of tax payers that is spent on investigating criminal conduct, formulating charges and ultimately prosecuting the culprits involved in corporate malpractice,” said Prof Gihwala.

According to Prof Gihwala the law continuously fails to hold companies meaningfully accountable to good and honest business values.

“Insider trading is a crime and, although legislation was introduced in 1998 to curb it, not a single successful criminal prosecution has taken place. While the law appears to be offering the public protection against unacceptable business behaviour, it does no such thing – the law cannot act as a deterrent if it is inadequate or not being enforced,” he said.

The government believed it was important to facilitate access to the country’s economic resources by those who had been denied it in the past. The Broad Based Economic Empowerment Act of 2003 (BBEE), is legislation to do just that. “We should be asking ourselves whether it is really possible for an individual, handicapped by the inequities of the past, to compete in the real business world even though the BBEE Act is now part of the law?,” said Prof Gihwala.

Prof Gihwala said that judges prefer to follow precedent instead of taking bold initiative. “Following precedent is safe at a personal level. To do so will elicit no outcry of disapproval and one’s professional reputation is protected. The law needs to evolve and it is the responsibility of the judiciary to see that it happens in an orderly fashion. Courts often take the easy way out, and when the opportunity to be bold and creative presents itself, it is ignored,” he said.

“Perhaps we are expecting too much from the courts. If changes are to be made to the level of protection to the investing public by the law, Parliament must play its proper role. It is desirable for Parliament to be proactive. Those tasked with the responsibility of rewriting our Companies Act should be bold and imaginative. They should remove once and for all those parts of our common law which frustrate the ideals of our Constitution, and in particular those which conflict with the principles of the BBEE Act,” said Prof Gihwala.

According to Prof Gihwala, the following reforms are necessary:

• establishing a unit that is part of the office of the Registrar of Companies to bolster a whole inspectorate in regard to companies’ affairs;
• companies who are liable to pay a fine or fines, should have the right to take action to recover that fine from those responsible for the conduct;
• and serious transgression of the law should allow for imprisonment only – there should be no room for the payment of fines.
 

Prof Gihwala ended the lecture by saying: “If the opportunity to re-work the Companies Act is not grabbed with both hands, we will witness yet another failure in the law. Even more people will come to believe that the law is stupid and that it has made fools of them. And that would be the worst possible news in our developing democracy, where we are struggling to ensure that the Rule of Law prevails and that every one of us has respect for the law”.

 

 

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