Interventional radiology (IR) is a specialty in which physicians use radiologic image guidance during minimally invasive procedures. IR can treat many conditions, including uterine fibroids, vascular disease, blood clots and cancer. When IR is used in cancer treatment, it is called interventional oncology. In some cases, interventional oncology can replace chemotherapy or traditional surgery.
Interventional Radiology Cancer Treatment Has Many Advantages
Interventional radiology often has many benefits for cancer patients. Instead of open surgery to remove tumors, which requires large incisions, IR procedures can destroy cancer cells using only small incisions or tiny punctures in the treatment area. Physicians use image guidance to deliver treatment directly to the tumor through these small openings. This process provides many advantages over traditional surgery:
- IR procedures can often be done on an outpatient basis.
- Instead of general anesthesia, IR often uses local anesthesia and sedation to keep the patient sleepy and relaxed during the procedure.
- When hospitalization is required, the length of stay is much shorter.
- Because IR procedures are precisely targeted, healthy tissue can be spared.
- Recovery is easier and faster, allowing patients to maintain their quality of life.
- In some cases, IR procedures are less costly than other types of treatment.
In cases where the cancer cannot be cured, IR can sometimes also be used to control symptoms and improve quality of life.
Types of IR Procedures for Cancer
Interventional radiologists perform a variety of image-guided procedures. For cancer, these include:
- Chemoembolization: This type of treatment can help reduce symptoms and improve the quality of life in patients with liver cancer or cancer that has spread to the liver. The physician will insert a catheter into the femoral artery in the groin. Using X-rays, the physician guides the catheter to the branch of the artery that is feeding the tumor, where chemotherapy medication is supplied directly to the tumor. Following this treatment, patients may experience short-term, self-limited side effects such as fever, pain and nausea, fatigue and loss of appetite.
- Radioembolization: This treatment is used to treat liver cancer or other types of cancer that have spread to the liver. The physician inserts a catheter into the groin, using X-rays to guide it into the hepatic artery, the main artery into the liver. Beads of a radioactive substance called yttrium 90 (Y90) are injected into the artery through the catheter. The beads collect in the tumor as well as blood vessels around the tumor, while the Y-90 gives off radiation, cutting off blood flow to the tumor and killing cancer cells. After being monitored for a period of time, you can usually go home following the procedure. However, you will need to limit your contact with others for the first week, as your body may give off radiation.
- Thermal ablation: Thermal ablation can be used to treat tumors in the liver, lungs and kidneys, as well as some breast and bone tumors. Thermal ablation includes heat (radiofrequency and microwave ablation) and cold (cryoablation) based technologies to kill tumors. The physician will insert a probe (needle-like device) into the skin and use CT scans, X-rays or ultrasound imaging to guide the probe into the center of the tumor. Depending on the location and type of tumor, the physician will choose the best and safest ablation modality for your treatment. Thermal ablation generally causes few side effects, and most people do not require a hospital stay.
Interventional radiologists also do image-guided procedures to place fiducial markers, which are small metal objects placed in or near a tumor prior to certain types of radiation therapy, including external beam therapy. The markers allow the treatment team to zero in on the tumor’s location with the radiation beams and spare the healthy tissue surrounding it.
Interventional Radiology vs. Diagnostic Radiology
Interventional radiologists and diagnostic radiologists have advanced training in many types of medical imaging, including:
Interventional radiologists use imaging to guide minimally invasive procedures. Diagnostic radiologists read and interpret medical images, which are used to:
- Help diagnose conditions
- Monitor a patient’s response to treatments
- Perform advanced imaging for diseases such as breast cancer, colon cancer and heart disease
Depending on the patient’s individual diagnosis and stage of treatment, medical imaging can be used to assist interventional radiologists with procedures or help physicians monitor treatment progress. In most cases, both interventional and diagnostic radiology will be needed during the course of diagnosis and treatment.