Interventional radiology offers a set of minimally invasive procedures for diagnosis, treatment, and palliative care for certain diseases, such as cancer.
This subspecialty in interventional radiology is also known as interventional oncology.
These procedures can be alternative options to open biopsies and surgeries, and are typically shorter, relatively less risky and associated with faster recovery.
Interventional oncology uses image-guided tools much like the GPS system to target the tumour area and perform diagnostic and therapeutic procedures in patients through the use of catheters, needles, and tiny probes (tiny instruments inserted into small incisions or natural body openings).
Procedures for diagnosis include image guided needle biopsy through the skin, angiography (study of blood vessels by injecting radiographic dye), and lymphangiography (study of lymph nodes by injecting radiographic dye).
Treatments are targeted to tumours in the bone, eye, visceral organs (internal organs in the body that include the lungs, liver, kidneys, etc.) and soft tissues. In most cases, these procedures result in no trace of surgical scars or sutures (stitches).
Diseases such as solid tumours and bone tumors, which were once exclusively diagnosed and treated through surgery, chemotherapy, or radiotherapy, can now be treated through interventional oncology procedures. However, these procedures are not appropriate for all cancer patients but based on individual patient factors such as:
- The tumour’s type, size and location
- The extent of the disease
- Whether the disease has spread to other areas in the body
Interventional oncology can be used in adults and paediatric patients with cancer. Currently, there are established interventional oncology protocols to treat certain cancers in adults. This experience is being used transferred to pediatric cancers where clinicians and researchers are expanding the ways it can be used to treat children.
Some of the cancers that can be addressed with this modality are:
- Soft tissue tumors such as Desmoid tumour
- Bone tumours such as osteoid osteoma, chondroblastoma, giant cell tumors, aneurysmal bone cysts tumours
- Liver tumours such hepatocellular carcinoma, hepatoblastoma, metastases
Lung and kidney tumours
Paediatric cancer treatment and adult cancer treatment can be very different, and it is important to find an interventional radiologist who knows how to treat paediatric patients specifically.
Two types of interventional radiology techniques that are used to treat cancer include targeted regional and ablative therapy:
- Targeted regional therapy delivers a combination of anti-cancer medication and agents that block the tumour blood vessels to shrink and kill a tumour. Intra-arterial chemotherapy, for example, delivers chemotherapy drugs to a tumour through a catheter placed into an artery feeding the tumor. Similarly, small beads coated with radiation properties can be selectively delivered to the tumour to help shrink and kill tumours.
- Ablative therapy uses either chemicals, heat energy, or cold energy applied locally to the tumour to destroy the tumour cells. In cryoablation, a hollow needle (cryoprobe) is inserted through the skin, through which cooled gases are circulated to destroy solid tumour tissue in the lung, liver, breast, kidney and soft tissues by freezing.
In addition to these procedure, interventional oncology also offers include central venous access placement such as chemotherapy ports and PICC lines, especially in patients with difficult anatomy. Drainage tubes through small skin holes are placed to remove excess or infected fluid from body cavities. Palliative care procedures aim to such at pleurodesis, nerve ablation, and tumour ablation help to reduce tumour-related pain and symptoms.
The interventional oncology team at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center is focused on advancing research in this area and further improving treatment options in paediatric cancers. This research includes making an archive of paediatric patients with solid tumours treated with interventional oncological procedures and developing a Biobank of samples and data in order to better evaluate the effectiveness of procedures and therapies.
Source: Dana Farber