Radiology & Interventional Radiology

What is Interventional Radiology?

By Dr Alex Tang
Consultant Vascular & Interventional Radiologist

Interventional radiology or in short, IR, is a sub-specialty of radiology in modern medical care. To put it in simple terms, it’s a minimally invasive and precisely targeted therapy option guided by X-ray equipment such as ultrasound, CT scan, angiogram, X-ray fluoroscopy or MRI. It is usually done under local anaesthesia with or without sedation. In most instances we can avoid general anaesthetic which can increase the complexity of the treatment exercise.

Most IR treatments are minimally invasive alternatives to open and laparoscopic (keyhole) surgery. These procedures are essentially a pin-hole puncture under radiological image guidance; hence it is sometimes called pin-hole surgery! Using fine catheter tubes and wires via the blood vessels like artery and veins or bodily channels such as the bile duct, kidneys and intestines, we are able to navigate around the body under imaging control. Interventional radiologists are doctors who are trained in radiology and interventional therapy.

 The roles of interventional radiology are:-

1. in complementing the medical and surgical treatment especially in patients who are critically ill and are not fit for open surgery or have failed medical treatment.

2. as a replacement for surgery in many situations such as treatment of liver metastases or liver cancer, or lung tumour where it can be burned off by using microwave ablation, radiofrequency ablation or cryoablation, or by selective injection of chemo drugs directly into the tumour through the artery. This is called TACE, transarterial chemo embolisation.

3. treatment of diseases which has no surgical or medical or oncological options.

4. It has developed and leapfrogged to the next level of treatment where many new procedures are being developed and this has enhanced the clinical outcomes.

The range of conditions which can be treated by interventional radiology is enormous and continually expanding. By instituting this treatment option, we are able to provide a vast number of procedures and treatment of various diseases previously only managed surgically or in situations where medical or surgical treatments are out of options.  Interventional radiology offers an alternative and can enhance clinical outcomes.

 A good example is in the treatment of cancer which we call  interventional oncology, where it has leapfrogged to its current state-of-art treatment by using tiny catheters or tubes inserted through the arteries or veins or directly into the tumour. 

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