Research focus

Molecular imaging

Relevance and importance to UP, South Africa and Africa

Non-invasive imaging is a powerful clinical tool for the early diagnosis, and monitoring of various disease processes.  Next generation molecular imaging promises unparalleled opportunities for visualizing disease since molecular and cellular alterations occur earlier in a pathologic process than structural changes. This rapidly developing technology has become an essential tool in the field of oncology, with similar potential for neurology, cardiology and infectious and inflammatory conditions. UP is ideally positioned to become the molecular imaging hub for Africa and to be a leading global research entity, under lead of Professor Mike Sathekge, a leading researcher in this domain.

The Molecular Imaging Research Centre is a multi-disciplinary, multi-institutional team committed to translation of novel probes from pre-clinical to clinical applications for improved healthcare. UP imaging researchers are core to the continued global growth of new strategies to improve targeted molecular imaging and therapy in TB, HIV and cancer. In addition to this, there is a significant drive towards increasing use of multi-imaging modality imaging approaches, which will unite basic and clinical scientists of various disciplines to develop cutting-edge applications for patient care.

The Department of Nuclear Medicine at University of Pretoria and Steve Biko Academic hospital is a national leading multidisciplinary platform with the development of positron emission tomography (PET) tracers, and new approaches in targeted radionuclide therapy.

This Department is home to one of the top registrar programs, PhD and fellowship programs.

The University hospital and department boasts several important developments and firsts in Africa and has won several international awards.

Thus based on outstanding research output and the scientific stature, the National Nuclear Medicine Research infrastructure (NuMeRI) Main Center will be at the Steve Biko Academic Hospital (also referred to as NuMaCS). NuMaCS will be equipped with a cyclotron, a GMP radiopharmacy production facility, plus state-of-the-art pre-clinical and clinical imaging modalities.

The research infrastructure will provide a framework to consolidate expertise and to implement new strategic initiatives in nuclear technologies in medicine and the biosciences, creating significant health research, development and innovation capacity in South Africa, both for academia as well as for commercially driven healthcare companies (pharmaceutical and biotechnology).

NuMeRI will be instrumental in capacitating the public health care sectors with critical and scarce skilled medical and scientific professionals through their access to and training in key infrastructure that is unique to their field(s).

Further, the department is one of the leading centers used by the International Atomic Energy Agency (IAEA) to train physician and radiographers in the continent.

The potential benefit to science and to society

The research group entered into a collaboration with the European Commission’s science and knowledge service, the Joint Research Centre (JRC), to develop a new breakthrough treatment for cancer patients.

The JRC is involved in a range of endeavours to advance scientific knowledge, and collaborates with expert scientists across the world to carry out research. It chose the Department of Nuclear Medicine for its expertise in the field of nuclear medicine.

The collaboration enables the Department to treat advanced-stage prostate cancer patients using targeted alpha therapy (TAT). TAT is very expensive and there are strict international security standards regarding nuclear safety. Thus, were it not for this collaboration, the Department would not have been able to treat its patients with this form of therapy. TAT using 225Ac-PSMA has proved to be very successful, with an 85% success rate in treating patients with advanced-stage prostate cancer.

Targeted alpha therapy (TAT) or alpha radiation is a fairly new approach to cancer treatment, which uses drugs to target specific genes or proteins which are found in cancer cells. By targeting these parts of a cancer cell, the cancer stops growing and spreading. The Department of Nuclear Medicine is one of only three platforms in the world that is using this form of treatment to treat advanced-stage prostate cancer specifically, using alpha isotopes known as Ac-225-PSMA. This is not only remarkable, but the fact that UP was selected to use this form of treatment highlights its exceptional leadership in targeted radionuclide therapy.

Alpha radiation can kill cells which otherwise exhibit resistance to treatment with beta- or gamma-irradiation or chemotherapeutic drugs, and can thus offer a therapeutic option for patients resistant to conventional therapies. Because alpha radiation has a very short range, cancer cells can be specifically targeted, while sparing healthy tissue. Patients, particularly those at a very advanced stage, undergo an imaging process to pick up abnormal cells and depending on the aggressiveness of the cancer, Prof Sathekge and his team is able to determine the course of radioactive therapy and administer TAT. This is usually a patient who has not shown any positive reactions to conventional therapies such as chemotherapy and hormone therapy.

Benefits to investing in this research area

The Department’s future plans is to look into the efficacy of alpha targeted therapy for breast cancer, melanoma and other cancers, as well as gaining a better understanding of epigenetics, the study of heritable changes in gene function that do not involve changes in the DNA sequence, to better understand the spread of cancer.

Prof Sathekge believes that in order to achieve optimal success in treating any form of cancer, a multidisciplinary approach is essential, from diagnosis all the way through to treatment. This approach should be very patient-specific and the course of treatment should be determined based on an individualised screening of each patient. The team of experts should include nuclear physicians, oncologists, radiologists, and surgeons working together to determine the best course of treatment for the patient.

Similarly, a flagship research project comprises a range of cutting edge technologies for infection and may lead to changes in the face of clinical medicine. A number of other prominent projects include novel radiopharmaceuticals, such as Ga68-UBI, Ga68-HIV-101,Ga68-TB-101 for infection imaging. These approaches are novel, effective but quite expensive and investment into this research area will positively contribute to health solutions to improve the lives of the ordinary citizen.