From the multicounter to theranostics: a story of nuclear medicine

Nuclear medicine is a medical specialty often misunderstood, both within and outside the medical community. Defined by the use of unsealed radiation sources for the detection and treatment of disease, the field encompasses functional imaging, tracer studies and targeted radiotherapies.

Modern nuclear medicine represents the convergence of pioneering work from across the 20th century, when radioactive compounds were first applied to medical science. From these early developments, the discipline has grown – interacting with and borrowing from sister fields – to become a dynamic area in modern healthcare.

Imaging technology has progressed from the initial use of the rudimentary multicounter to today’s hybrid systems that offer exquisite anatomical and functional detail. Advances in biochemistry and radiopharmacy now allow the visualisation of cellular processes and the delivery of precision therapies with fewer side effects.

In his inaugural lecture, Prof James Warwick offers a personal perspective on the origins and evolution of nuclear medicine. He reflects on its development from modest beginnings, the technological breakthroughs that have shaped it since, and how cross-disciplinary innovation continues to drive the field forward.

WATCH THE INAUGURAL LECTURE HERE

Short biography

Prof James Warwick is the executive head of the Department of Medical Imaging and Clinical Oncology as well as the head of the Division of Nuclear Medicine at Stellenbosch University (SU) and Tygerberg Hospital.

Born and raised in Cape Town, he initially aspired to a career in physics and completed a BSc with majors in Physics and Applied Mathematics at the University of Cape Town (UCT). He later changed direction to pursue medicine, entering the MBChB programme at UCT and completing his internship at Groote Schuur Hospital.

Following clinical experience in accident and emergency medicine as well as orthopaedic surgery in the United Kingdom, he returned to South Africa to join the Nuclear Medicine registrar programme at SU. Prof Warwick has served as a specialist in the Division of Nuclear Medicine at Tygerberg Hospital since 2000. In 2001, he also completed a fellowship in brain imaging analysis at the Catholic University of Leuven and the University of Ghent, both in Belgium.

Prof Warwick has produced approximately 80 book chapters and peer-reviewed journal articles. His research interests include the application of functional brain imaging in psychiatry and neurology, the role of PET/CT imaging in infectious diseases, and the assessment of renal function. Five doctoral and 19 master’s candidates have benefited from his supervision.

With nearly 25 years’ experience in teaching, training and examining Nuclear Medicine trainees, Prof Warwick has made a substantial contribution to the field. He served three terms as president of the College of Nuclear Physicians of the Colleges of Medicine of South Africa from 2011 to 2020. He has also held various leadership positions in the Association of Nuclear Physicians (ANP) and the South African Society of Nuclear Medicine (SASNM), including serving as SASNM president from 2014 to 2016.