Interventional radiology

Interventional radiology is a rapidly developing and growing branch of medicine.

The techniques of interventional radiology are used for many different types of cancers and at different stages of the disease.

These treatments are grouped together because they are all done by interventional radiologists using image guidance such as x-ray, ultrasound or CT scans.

The procedures are all minimally invasive (keyhole), usually done using local anaesthetic and sometimes stronger painkillers and sedatives.

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  • Tumour biopsy

    A needle biopsy is often required to diagnose a specific type of cancer. This is because treatments are becoming more and more specific to each type of cancer.

    A needle biopsy involves the interventional radiologist scanning you (usually with an ultrasound scanner or CT scanner) and finding a safe path through your skin into the tumour. Local anaesthetic numbs your skin and sometimes sedation is used.

    A small amount of tumour tissue is removed on the end of the needle and placed onto a slide. The tissue is then examined by a pathologist who can diagnose whether or not it is cancerous.

    The tissue examination process usually takes at least a week. The pathologist’s findings are then sent back to the specialist doctor primarily responsible for your care.

    Macmillan has a range of information on biopsies.

  • Relief of obstructions

    Sometimes cancers can grow inside your body and cause blockages of important tubes or ducts, for example the ureter, which is the tube that connects your kidney to your bladder.

    Interventional radiologists have many techniques using small tubes (catheters) and guidewires, which allow them to reach these important parts of your body through small cuts in the skin.

    They may leave a temporary plastic tube inside the blocked structure to allow fluid to flow.

    Alternatively, they may insert a mesh cylinder called a stent, which offers a long-term solution to the problem.

    Examples of stents include:

  • Thermal ablation

    Thermal ablation is used to slow down cancer growth and can sometimes kill the cancer completely.

    Interventional radiologists can direct special needles or probes through your skin directly into cancer cells in parts of your body such as your liver, kidney, lung and bone.

    The needle is directed into the correct part of your body using an ultrasound or CT scanner.

    When the probe has been positioned in the middle of the cancer, it is connected to a special generator. This causes the tip of the probe to heat up the cancer cells to more than 60 degrees Celsius. This kills off cancerous cells.

    These procedures can be done under full general anaesthetic or local anaesthetic and sedation.

    Thermal ablation is suitable for a relatively small number of patients as the cancer deposits usually need to be quite small and low in number.

    There are several types of thermal ablation, but the most common are radiofrequency ablation or microwave ablation.

    Macmillan has a range of information on thermal ablation.

  • Chemoembolisation

    Chemoembolisation is a treatment most often used to slow down different types of liver cancer.

    The interventional radiologist passes a small tube (catheter) into the main artery in your groin. They can then direct it up through the main blood vessels in your body and into the artery that supplies your liver.

    When it’s in place, a special mixture of tiny plastic particles with a chemotherapy drug bonded onto them is injected into that artery.

    These tiny particles then flow into your liver and release the drug straight into the cancer cells. This means the cancer cells are exposed to a higher concentration of the chemotherapy drug.

    It is also possible to bond a special radioactive material onto these tiny plastic particles. When the particles are released from the catheter, they get stuck in the tiny blood vessels inside the cancer. The radiation then goes straight into the cancer.

    This is a highly specialised and expensive procedure only suitable for a small number of patients. It is called radioembolisation.

    Macmillan has a range of information on chemoembolisation.