The roots of Nuclear Medicine in South Africa can be traced to the import of the first radioisotopes for medical use in 1948.
The Pretoria General Hospital bought a sodium iodide counter in 1952. The first rectilinear scanner was installed in 1964 on the premises of the CSIR in Pretoria, and the first gamma camera was installed at the Pretoria General Hospital in 1969.
Nuclear Medicine grew to become a subspecialty under Radiology in 1980 and then a separate speciality in 1987. Currently seven of the country’s teaching hospitals have a department of Nuclear Medicine with PET/CT and state-of-the-art gamma cameras, including SPECT/CT. Private Nuclear Medicine facilities with modern equipment are available in the majority of private hospitals in the larger centres. Nuclear Medicine services continue to expand outside of the main metropolitan areas.
The South African Society of Nuclear Medicine (SASNM) was founded in 1974. It is one of the oldest Nuclear Medicine societies (and probably the most active) on the African continent. The SASNM has approximately 200 members, including nuclear medicine physicians, radiographers, physicists, radiopharmacists and scientists from various specialties. Scientific congresses with international participation have been held biennially since 1974.
Most of the tertiary academic institutions in South Africa provide ongoing post-graduate training in Nuclear Medicine. The post-graduate training programmes for doctors comprise a period of at least 4 years with core competencies in medical physics, radiobiology, radiation protection, radiopharmacology and clinical Nuclear Medicine. Post-graduate training is also provided for physicists in Nuclear Medicine. Radiographers specialising in Nuclear Medicine undergo a minimum of 3 years training leading to a diploma or a BTech degree. The Health Professionals Council of South Africa and the National Department of Health strictly control the training, in line with international requirements.
Through the African Regional Co-operative Agreement (AFRA) with a membership of 24 African countries, South Africa assists the International Atomic Energy Agency (IAEA) by hosting regional training courses. Several people from Africa have already attended short regional training programs and fellowships of up to a year including doctors, physicists, radiographers and laboratory technologists.
South Africa has a well-established infrastructure for production of radionuclides. The Nuclear Energy Corporation (NECSA) has a 20 MW multipurpose reactor that has been operating since 1965 with molybdenum export production capacity of 1000 Ci weekly. Technetium generators and most diagnostic kits are produced at the NECSA’s Isotope Production Centre.
Accelerator radionuclides were initially produced from 1955 at the low energy CSIR cyclotron in Pretoria. In February 1987, the National Accelerator Centre (since December 2001 - iThemba LABS) near Faure, Western Cape, started the routine operation of a variable-energy multi-particle separated sector cyclotron (Ep-200MeV). Production of short-lived radionuclides and radio- pharmaceuticals at this facility supplies more than 30 hospitals, clinics and institutes in Southern and Central Africa. The isotopes produced include 18F, 123I, 67Ga, 139Ce, 75Se, and long-lived isotopes such as 22Na, 55Fe, 82Sr, 68Ge, 103Pd, and 133Ba.
Nuclear Medicine has evolved in South Africa parallel to developments in medicine in general. The first heart transplant, the conception of the CT scanner and other significant medical achievements have not been isolated events, but are part of a dedicated process to achieve the highest levels of medical and scientific competence. Nuclear Medicine in South Africa is rapidly growing and evolving as well as acting as a reliable support system for colleagues in Africa. Nuclear Medicine in South Africa is looking forward to a bright future.
© SASNM 2021