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The first clinical PhD in nuclear medicine completed at the UFS

18 April 2024 | Story Andre Damons | Photo Charl Devenish

Dr Osayande Evbuomwan, Senior Lecturer and Medical Specialist in the Department of Nuclear Medicine, Faculty of Health Sciences, at the University of the Free State (UFS), graduated with the first clinical PhD in nuclear medicine completed at the UFS.

He graduated on Thursday (18 April 2024) at the university’s autumn graduation ceremonies when the Faculty of Health Sciences conferred degrees on its graduation class of 2024.

Dr Evbuomwan, the man behind his department using Lutetium 177 PSMA (Lu-177 PSMA) therapy and now Actinium 225 PSMA therapy to treatment metastatic castrate resistant prostate cancer (MCRPC) – an advanced stage prostate cancer, said his PhD is about using a special radiopharmaceutical called Technetium 99m ECDG to detect active disease in the joints of patients with rheumatoid arthritis (RA).

More opportunities for similar degrees

This research has won him the Society of Nuclear Medicine and Molecular Imaging (SNMMI) International Best Abstract Award for South Africa during last year’s SNMMI 2023 Annual Meeting in the US.

“I am very grateful, and at the same time, proud about this achievement (his PhD). This qualification will definitely give more opportunities for further similar degrees at the department. So yes, I feel very happy and fulfilled.

“Rheumatoid arthritis is a debilitating disease with associated morbidity that can lead to serious joint deformity and destruction. The need for an investigation with a very high diagnostic accuracy in detecting active disease is needed, especially in the detection of subclinical disease. Few prior studies in the literature had shown promising results with Tc 99m ECDG imaging in this regard. So, we decided to conduct a proper prospective study to test this hypothesis,” says Dr Evbuomwan.

This research, he explains, was also aimed at finding out if the new nuclear medicine radiopharmaceutical for the identification of active disease in patients with rheumatoid arthritis can also offer prognostic information. This aspect of the study concluded that this particular radiopharmaceutical (Tc – 99m ECDG) is highly sensitive in identifying synovitis (inflammation of the membrane that protects joints) and is capable of offering prognostic information in patients with rheumatoid arthritis.

This was the first prospective study to assess the prognostic value of this radiopharmaceutical in patients with rheumatoid arthritis, Dr Evbuomwan says.

Researching theranostics in the future

According to him, he had a smooth journey to completing his PhD – something he contributes to support from the fantastic team of three supervisors, the assistant who prepared the radiopharmaceutical, the rheumatology department, the radiographers and nurses at the Department of Nuclear Medicine, and most importantly, his wife and two daughters.

His passion for research, growth and the practice of nuclear medicine were his major motivators on this journey.

Dr Evbuomwan is currently looking at the possibility of starting research on theranostics. The only stumbling block for now, he says, is that the department still does not have a PET/CT camera, as this is very vital in today’s nuclear medicine practice. However, together with the Free State Department of Health, they are working hard to secure one.

“I now want to focus on nuclear medicine therapy and its promotion. This includes both imaging and treatment (theranostics) of certain cancers, most especially prostate cancer, neuroendocrine neoplasms, thyroid cancers and the neuroectodermal tumours. I also want to focus on being involved with the training of more registrars at the department of nuclear medicine and increasing the awareness of nuclear medicine amongst colleagues in the Free State,” says Dr Evbuomwan about his future plans.

News Archive

Nuclear Medicine on the forefront of cancer research

2017-07-10

Dr Je’nine Horn-Lodewyk’s tumour detection method
could be the cost-effective breakthrough needed to decrease
the mortality rate in breast cancer patients.
Photo: Anja Aucamp

The field of Nuclear Medicine in South Africa and the rest of the world are expanding rapidly due to the development of hybrid cameras and new radiopharmaceuticals. These developments have a huge impact on the diagnosis and therapy of cancer.

The most advanced of these cameras, Positron emission tomography combined with normal CTs (PETCT), are not yet widely available in South Africa due to the cost of the cameras and the radiopharmaceuticals. A more cost-effective alternative can be of great benefit. To achieve this, the focus should be on developing new radiopharmaceuticals that can be used with the current cost-effective gamma cameras, according to University of the Free State researcher, Dr Je’nine Horn-Lodewyk from the Department of Nuclear Medicine.

Fluorodeoxyglucose (18F-FDG), a radiolabelled glucose analogue, is currently the radiopharmaceutical most commonly used in PET/CT imaging for mainly oncology indications. Although it is considered the gold standard for imaging in several malignancies, it does have certain disadvantages. An 18F-FDG PET/CT diagnostic imaging study can cost between R25 000 and R35 000 for a single patient in the private sector. The 18F-FDG is also more radioactive, which requires much stricter handling and shielding to avoid high radiation dosages to staff and patients.

Successful research potential innovative solution
In the search for the ideal radiopharmaceutical for tumour detection, the South African National Nuclear Energy Corporation (Necsa) developed a local synthesis process for ethylenedicysteine-deoxyglucose (EC-DG). EC-DG is also a glucose analogue similar to FDG. They succeeded in labelling the compound with Technetium-99-metastable-pertechnetate (99mTcO4-), the most common nuclear medicine isotope used for approximately 95% of nuclear medicine procedures, creating 99mTc-EC-DG.

In partnership with Dr Horn-Lodewyk, this compound was successfully used in various animal models and clinical scenarios, resulting in approval by the Medicine Control Council to use it in a human study. Research is also planned in order to investigate diagnostic accuracy in other cancers like lymphoma. The end result of this research can produce a radiopharmaceutical that is cost effective, does not require the use of costly specialised equipment, has no significant side-effects, no special patient preparation, renders late imaging possible, and has decreased radiation risks.

Dr Horn-Lodewyk is grateful for the support of her mentor, Prof Anton Otto, as well as Dr Gert Engelbrecht, Head of the Department of Nuclear Medicine, Prof Jan Rijn Zeevaart from North-West University’s Preclinical Drug Development Platform and Necsa, and Judith Wagener from Necsa. This innovative research would also not have been possible without the financial assistance of Dr Glen Taylor and Eleanor van der Westhuizen in the Directorate of Research Development.

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