18 Sep, 2024
18 Sep, 2024
This article is medically reviewed by Dr. Sumit Sharma, Consultant – Interventional Radiology, HCG Cancer Centre, Kolkata
Interventional radiology is a branch of medicine that involves the use of imaging techniques, such as computed tomography, ultrasound, x-rays, or magnetic resonance imaging, to diagnose and treat various conditions.
Experienced radiologists perform procedures involving interventional radiology. In several cases, interventional radiology procedures eliminate the need for surgery and/or hospitalization.
The advantages of interventional radiology include minimal complications, less overall cost, shorter hospital stays, and a brief recovery period.
Some of the most common interventional radiology procedures are:
Angiography is an interventional imaging technique used to determine the health of blood vessels. Angiography makes use of several imaging techniques, including X-ray imaging and computed tomography. The technique is a gold standard for determining various vascular conditions
The advantages of angiography include dynamic, real-time imaging and the fact that it offers treatment options during the initial diagnosis.
Angiography assists in the diagnosis of atherosclerosis (narrowing of the arteries), peripheral arterial disease, brain aneurysm (bulging of brain blood vessels), pulmonary embolism (blockage in lung arteries), and blockage in the kidney arteries.
During angiography, the doctor makes an incision in the wrist or leg to expose an artery. The doctor then places a flexible, thin tube, called a catheter, into the artery and guides it to the heart.
Once the catheter has reached the desired place, the doctor injects the contrast agent (dye) into the catheter. The radiologists then take a series of X-ray images to follow the dye flow into the blood vessels. The images obtained in the angiography are known as angiograms.
Angioplasty is an interventional radiology technique used to open narrowed or blocked arteries. It is a minimally invasive procedure that eliminates the need for open-heart surgery to restore the flow of blood into the arteries.
The technique is immensely useful in various emergency conditions, such as heart attacks. It is also used to open arteries in other body parts, such as the legs, arms, neck, pelvis, and kidneys.
Once the doctor detects the narrowed or blocked artery during angiography, a wire and a separate catheter are inserted into the artery. This catheter has a balloon at the tip. When the catheter reaches the problem site, the doctor inflates the balloon and widens the clogged artery to improve the blood flow.
Embolization is a minimally invasive procedure generally used to stop arterial blood flow. It is usually a planned procedure, but it is sometimes used as an emergency procedure.
The technique is used in various conditions, such as bleeding from traumatic injury, gastrointestinal lesions, vascular malformations, tumors, and long menstrual periods.
It also prevents blood flow to the vessels providing blood to a tumor, eliminates arteriovenous fistulas or arteriovenous malformations, reduces the size of congenital venous malformations, and treats varicoceles and aneurysms.
Imaging techniques are used before and during the procedure. Before the procedure, the doctor uses computed tomography, ultrasound, or magnetic resonance imaging to accurately detect the site of the procedure.
During the procedure, X-rays are used to detect the flow of contrast dye in the vessels. The doctor may also take additional X-ray images at the end to analyze the procedure's outcome.
Gastrostomy tubes, also called G-tubes, are feeding tubes that are placed to deliver various substances directly into the stomach. These include liquids, children's formula, and medications.
Placement of the gastrostomy tube is required in several conditions, such as congenital problems related to the esophagus, mouth, or stomach; swallowing or sucking disorders; severe issues in taking medications; gastrointestinal cancers; injuries affecting the digestive system; paralysis; stroke; short bowel syndrome; and intestinal failure.
Gastrostomy tubes may be placed through various procedures, including endoscopy, radiology, and laparoscopy. The radiological placement of the gastric tube involves the use of ultrasound, computed tomography, or fluoroscopy. The technique is known as percutaneous radiological gastrostomy.
It is a minimally invasive procedure used to evaluate the blood vessels internally. It involves using ultrasound to detect the blockage or narrowing of the blood vessels. The technique is also known as endovascular ultrasound, coronary intravascular ultrasound, or intravascular echocardiography.
The technique is used to diagnose various serious conditions, such as pulmonary embolism, heart attack, and stroke. Intravascular ultrasound also assists doctors in determining the need for stent placement in a particular patient.
In contrast to angiography, which uses X-rays and provides two-dimensional images of the arteries, intravascular ultrasound uses sound waves to provide cross-sectional images.
Stent placement involves inserting a tiny, hollow metal tube into the arteries to ensure proper blood flow. It is usually done after angioplasty to avoid re-narrowing the arteries.
The stent may be placed at several arteries in the body, such as the coronary (heart) artery, kidney (renal) artery, neck (carotid) artery, and the legs (peripheral artery). Stent placement may use various imaging procedures at different stages. During angiography and angioplasty, the procedure uses fluoroscopy (x-ray imaging) to detect and remove the blockage in the arteries.
Stent placement may be performed under intravascular ultrasound guidance to ensure optimal stent expansion and apposition.
Interventional radiology procedures are also implemented to place the catheters to diagnose and treat several medical conditions.
Several image-guided percutaneous catheter placement procedures are available to ensure the correct catheter placement. These procedures help reduce complications and improve overall procedure outcomes.
Image-guided catheter placement is a minimally invasive procedure performed under various imaging techniques, such as fluoroscopy (X-ray imaging) and ultrasound. Studies reported good catheter survival and reduced catheter complications and malfunction rates with image-guided catheter placement.
Image-guided catheter placement offers several advantages over laparoscopic surgery, such as less tissue damage, reduced overall cost, and avoiding general anesthesia.
Interventional radiology also has applications for removing foreign bodies. A study reported that ultrasound-guided detection and removal of the foreign body through a nonsurgical approach should be considered a first-line procedure.
Metallic, vegetal, and glass foreign bodies require removal. Ultrasound has the advantage of detecting all types of materials and is thus an imaging technique of choice for evaluating suspected foreign bodies.
The other radiological techniques used are magnetic resonance imaging, computed tomography, and plain radiography images.
Biopsy is the technique for determining whether a tumor is infectious, benign, or malignant. Several methods are used to perform biopsies, including needle biopsy, endoscopic biopsy, surgical biopsy, punch biopsy, and laparoscopic biopsy.
Image-guided needle biopsy is one of the most common methods used for biopsy, especially to obtain samples from hard-to-reach organs such as the liver, kidneys, lungs, lymph nodes, and bones.
Several imaging techniques are used to guide the needle to an accurate site for sample extraction. These imaging techniques include ultrasound, fluoroscopy, computed tomography, magnetic resonance imaging, and X-ray imaging. It is a minimally invasive technique that improves success rates and offers shorter recovery times and fewer risks.
Vertebroplasty and kyphoplasty are procedures to treat spinal compression fractures. They aim to relieve the symptoms of the fracture, such as reduced height with age, back pain, and limited spinal movement.
During vertebroplasty, the doctor injects quick-setting cement directly into the affected vertebrae to support the spinal column. Kyphoplasty is an advanced version of vertebroplasty that involves placing a balloon between the spinal vertebrae to make them taller. The balloons are removed, and the doctor fills the space with quick-setting cement.
Diagnostic imaging is critical for vertebral compression fractures. Doctors may often use conventional radiographs of the lumbar or thoracic spine to diagnose these fractures. However, magnetic resonance imaging is usually preferred because of its accuracy.
Nuclear medicine bone scans and computed tomography may be used in patients who cannot undergo magnetic resonance imaging. Radiological imaging techniques are also used during the procedure.
Nephrostomy is a minimally invasive procedure in which a small catheter is placed into the kidney to collect urine. The technique is used in patients with a block in the urinary flow, which could be caused by kidney infection, kidney stones, trauma, tumors, swelling, scar tissues, or congenital conditions affecting the urinary system.
Imaging techniques, like magnetic resonance imaging, nuclear medicine , computed tomography, or ultrasound, are used to diagnose renal obstruction.
The procedure of placing the catheter into the kidney, also known as percutaneous nephrostomy placement, is usually done under imaging guidance (computed tomography, fluoroscopy, or ultrasound) to minimize complications and injury to the surrounding organs.
It is a method for treating uterine fibroids. UFE shrinks fibroids and helps manage their symptoms. During uterine fibroid embolization, the blood supply to the uterus is blocked, resulting in the shrinking of the fibroids.
The doctor injects a contrast medium (dye) into the catheter during this procedure. X-rays follow the dye to determine the artery that needs to be blocked. Once the artery is detected, the doctor injects small particles into it to block it.
X-rays are also taken after the completion of the procedure. It is to ensure that the artery is completely blocked.
HCG Cancer Centre, Kolkata, is an advanced facility for the diagnosis and treatment of various types of cancer with comprehensive care.
HCG Oncology has always strived to improve patient outcomes through technological innovation. Procedures involving interventional radiology are effective, safe, and comfortable for patients.
The hospital has all the required facilities related to radiology and imaging services for minimally invasive image-guided diagnosis and treatment of various cancers, such as breast and bone marrow cancer, and benign tumors, such as uterine fibroids.
The interventional radiology team at HCG comprises interventional radiologists, surgeons, radiation oncology specialists, and a team of well-trained paramedical staff.
Interventional Radiology Services Available at HCG Cancer Centre, Kolkata:
Interventional radiology utilizes advanced imaging techniques to diagnose and treat various conditions, often eliminating the need for surgery.
Angiography, angioplasty, and embolization are a few procedures that are more popular on the interventional radiology procedures list. These procedures serve as minimally invasive alternatives with benefits such as real-time imaging and shorter recovery.
Additionally, catheter insertions and image-guided biopsies enhance diagnostic accuracy while minimizing risks and recovery time.
Dr. Sumit Sharma
Consultant – Interventional Radiology
MD (Radiodiagnosis), Fellowship (Onco - Imaging & Intervention)
Dr. Sumit Sharma is an adept interventional radiologist practicing at HCG Cancer Centre, a leading cancer hospital in Kolkata. His core knowledge lies in the field of cancer imaging and interventions. His expertise lies in performing image-guided biopsies, guided drainages, PTBD, PCN, tumor ablations, etc. He also specializes in performing certain cancer therapeutic procedures and administering palliative care to cancer patients. Dr. Sumit has a special interest in thoracic imaging, especially ILD.
To book an appointment with Dr. Sumit Sharma, please click here.
