Interventional Oncology

All procedures are performed at Atrium Health's Carolinas Medical Center Interventional Radiology department. In addition, chemoembolization, radiofrequency ablation and cryoablation procedures are offered at Carolinas Healthcare System - NorthEast's Interventional Radiology department. Our radiologists work directly with your oncologist to coordinate a treatment plan that best meets your needs.

To schedule a consultation with an interventional radiologist please call 704.358.IRMD (4763).

Chemoembolization is a minimally invasive treatment for liver cancer. Using x-ray imaging for guidance, a small catheter is advanced into the blood vessels supplying the liver cancer. This method is used to deliver a highly concentrated dose of cancer-killing chemotherapy drugs directly into the blood supply feeding the tumor. At the same time, the vessel is blocked (embolized) by tiny particles. This procedure is able to accomplish several things:

1. The particles act to shut off blood supply to the tumor and trap the chemotherapy drugs inside the tumor. The tumor is deprived of nutrients and oxygen and is exposed to a high concentration of chemotherapy for an extended period of time.
2. The chemotherapy drugs are delivered directly to the tumor site so the effective dosage to the tumor is up to hundreds of times more than if it was administered through an IV in the arm or through a port.
3. Since most of the chemotherapy drugs stay within the liver, there is decreased circulation throughout the body and less systemic side effects.

Chemoembolization is effective for treatment of both tumors that originate in the liver (primary liver cancer) or metastatic tumors that have spread to the liver from other cancer sites (i.e. colorectal, breast, carcinoid, etc.)

Similar to chemoembolization, interventional radiologists use radioembolization to deliver treatment directly to the liver tumor using a catheter and imaging tools like real time X-ray. The difference is that radioembolization treats the tumor with radiation particles or radioactive microspheres. The microspheres block the blood supply to the tumor while delivering targeted radiation directly to the tumor. There are two types of spheres used based on whether the liver cancer is primary or metastatic:

• SIRSpheres - Uses resin microspheres containing the radioactive isotope Yttrium-90 to treat metastatic liver tumors.
• TheraSpheres - Uses glass microspheres containing the radioactive isotope Yttrium-90 to treat primary liver tumors.

Microwave Ablation (MWA) is a procedure where a microwave antenna is advanced directly into a tumor using imagingtools like CT or ultrasound. The ablation antenna uses microwave energy to cause rapid rotation and agitation of water molecules to create friction and heat, which causes tumor cell death. Compared to other thermoablative devices, a couple advantages of microwave ablation is the ability to create a larger ablation zone in a shorter period of time. It can be used to treat primary and metastatic liver cancers, kidney and adrenal tumors, primary and secondary lung malignancies, and bone metastases. This procedure is helpful in relieving symptoms and extending survival. It has been shown to be an effective tool used in conjunction with other cancer therapies, such as chemotherapy, transarterial chemotherapy (TACE), radioembolization, and surgical resection.

Radiofrequency ablation (RFA) shrinks and kills tumor cells using heat from radiofrequency energy. It is often used to treat kidney, lung and both primary and metastatic liver cancers. An ablation needle is inserted into the skin and imaging - tools such as CT or Ultrasound allow the radiologist to direct the needle, and ultimately the heat, directly to the tumor destroying the cancer cells. Scar tissue replaces the cancer cells. The procedure is helpful in relieving symptoms and extending survival.

Cryoablation freezes and kills cancerous tissue. A needle, or cryoprobe, is filled with argon gas, which results in rapid freezing of the tissue to temperatures of -100 degrees Celsius; and the tissue is then thawed by replacing the argon with helium. This process consists of two freezing and thawing cycles, to obtain a frozen ablation margin of at least 5 millimeters beyond the tumor edge to ensure death of the entire tumor.

Our Body and Interventional Radiologists use imaging tools such as CT or Ultrasound to direct the placement of the cryo needle. This particular procedure is commonly used for lung, liver, kidney, prostate and breast cancers, when surgery is not an option.

Additional information on these procedures can be found at:
» www.radiologyinfo.org
» www.SIRweb.org