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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

UFS doctors fight childhood cancer
2016-09-02

Description: Childhood cancer  Tags: Childhood cancer

Prof David Stones and Dr Jan du Plessis of the
University of Free State’s paediatric oncology ward
are helping little lives, one patient at a time.
Photo: Nonsindiso Qwabe

Of 23 paediatric oncology specialists nationally, Prof David Stones and Dr Jan du Plessis of the University of Free State are the only ones in the province.

Committed to giving holistic care to their patients, the two doctors specialise in all types of childhood cancers, the most common being leukaemia, brain tumour, and nephroblastoma.

They describe the childhood malignancy as a lethal disease, unpredictability being its harshest trait. “With cancer, you can just never know. It precipitates and multiplies, and leads to the failure of other organs. You can just always hope, and keep trying,” said Du Plessis.

The paediatric oncology unit of the Universitas Academic Hospital, their unit, is the liveliest floor in the entire building. It is also the third busiest in South Africa, serving a demographic that spans the Free State and Northern Cape, as well as parts of North West, Eastern Cape and Lesotho.

Each year, the unit receives more than 100 new childhood cancer patients. In 2015, the unit had 113 newly diagnosed patients, an increase from 93 in 2014.

Lack of knowledge poses a serious challenge
According to the two experts, the lack of insight and awareness of the disease remain a big challenge to fighting it. “It is frustrating. Parents and family members don’t know anything about it. Nurses and doctors aren’t always clinically trained to pick up the early warning signs. By the time a diagnosis is made, life and death is on a 50% margin,” Stones said.

Poverty, a lack of resources, overcrowding and a range of health issues are other factors that have a profound effect on the diagnosis and treatment of the disease.

Making a contribution that will last
With a desire to see an improvement on life outcomes in the health sector, the team is focusing on educating the country’s doctors of tomorrow. Their unit is the only one in the country that actively involves medical students in an oncology unit, giving them practical experience and exposure to the individual cases each patient presents. They have also produced a substantial amount of research literature on childhood malignancies in South Africa as a developing country.

Driven by passion to see a better South Africa
The doctors are passionate about the work they do, and remain hopeful there will be a change in the incidence of childhood cancer   not just in decreased levels of the disease, but also in the overall state of well-being of young South Africans.

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