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Interventional Radiology is an area of medicine which combines diagnostic imaging with invasive procedures. The imaging is used in targeting, guiding, and monitoring the treatment that is performed by the interventional radiologist (IR). The general aim is to minimize the invasiveness of the procedure, resulting in a shortened recovery time. This often leads also to a less painful operation, a reduced need for general anesthesia, and a diminished risk to the patient.
History
The advancements in the field of radiological imaging, together with innovations in instrumentation, led to a rapid development in interventional procedures in the 1970s. Cardiovascular precedures were found out to be particularly well-suited for guided and minimally invasive operations, and catheterization remains as one of the main applications for interventional radiology.
Imaging Methods
Common interventional imaging methods include X-ray fluoroscopy, computed tomography (CT), ultrasound (US), and magnetic resonance imaging (MRI). Fluoroscopy and computed tomography use ionizing radiation that may be potentially harmful to the patient and, in the case of fluoroscopy, the interventional radiologist. However, both methods have the advantages of being fast and geometrically accurate. Ultrasound suffers from image quality and tissue contrast problems, but is also fast and inexpensive. Magnetic resonance imaging provides superior tissue contrast, at the cost of being expensive and requiring specialized instruments that will not interact with the magnetic fields present in the imaging volume.
Procedures
Typical interventional procedures are:
- Balloon angioplasty, opening of blocked vessels by inflating a small balloon inside a vessel
- Chemoembolization, delivering cancer destructing agents directly on the treatment volume
- Cryoablation, localized destruction of tissue by freezing with a cold-head
- Drainages, where fluids are drained from the body through tubes or needles
- Embolization, delivering clotting agents on a bleeding volume
- Laser-induced thermal therapy (LITT), localized destruction of tissue by heating with an intense light-beam.
- Needle biopsy, taking of a tissue sample from the area of interest for pathological examination
- Radiofrequency (RF) ablation, localized destruction of tissue by heating with RF radiation
- Venous access, injecting or draining fluids from the blood-stream
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