Interventional Radiology: The Basics
What is Interventional Radiology (IR)?
Interventional Radiology (IR) uses imaging, such as ultrasound, x-ray, CT, MRI, and fluoroscopy to see inside your body so your doctor can do minimally-invasive procedures. “Minimally-invasive” means that the doctor does not need to make a large incision (cut). Instead, one or more small “punctures” or holes are made, causing less damage to the body. Many procedures that used to require surgery can now be done by an Interventional Radiologist. IR procedures may be done to diagnose or treat a disease.
These procedures are done in an operating room type setting. You can often can go home the same day.
Who makes up the IR team?
The IR team is made up of many providers:
- An Interventional Radiologist (IR) is a doctor who is Board Certified in Radiology and is trained to do minimally-invasive image-guided procedures.
- The Interventional Radiologist is assisted by a radiology technologist and a nurse.
- The technologist helps the interventional radiologist during the procedure.
- The registered nurse will keep an eye on your vital signs and give medications to make you sleepy and for pain control.
- You may also see a Physician Assistant (PA) and/or Nurse Practitioner (NP) who will guide you through your procedure and let you know what to expect after it is done. The PA or NP may be the person you will call for your follow-up and plan of care.
How is IR used in treatment?
IR can be used to treat many health issues, such as:
- Uterine fibroids.
- Deep vein thrombosis (DVT).
- Varicose veins.
Often, cancer is treated with chemotherapy, surgery, and/or radiation. Some cancers that once needed surgery or chemotherapy can now be treated with IR. In some cases, IR may be used to manage side effects or place a central line catheter.
Almost all patients with cancer will see an Interventional Radiologist at some point during their treatment. Depending on your type of cancer, an Interventional Radiologist may become one of your primary physicians or work closely with your oncologist or surgeon.
How are IR procedures done?
IR procedures are done in an operating room like setting. You will see a lot of equipment used to image your body as well as ones to do the procedure. A small puncture (hole) in the skin the size of an IV needle is used. This is called a “percutaneous” hole. IR procedures often do not need an incision (cut) or sutures. Specific procedures are listed below.
What are types of IR procedures?
Interventional Radiology performs many types of procedures. Some of these procedures are:
- Transarterial Chemoembolization (TACE).
- Radioembolization (SIRspheres or THERAspheres).
- Thermal Ablation:
- Microwave or radiofrequency ablations.
- Alcohol ablation therapy.
- Central Venous Access Devices (Port-a-catheters, Hickman catheters, pheresis catheters, and peripherally inserted central catheters [PICC] lines).
- Nutrition Supplementation Tubes:
- Gastrostomy tubes (G-tubes).
- Jejunostomy tubes (J-tubes).
- G-J combination tubes.
- Inferior vena cava filter (IVC filter) Placement and Removal.
- Deep Vein Thrombosis (DVT) Thrombolysis and Thrombolectomy.
- Tunneled Intra-Peritoneal Drains (IP drains) and Denver Shunt.
- Tunneled Pleural Catheters (PleurX).
- Transjugular Intrahepatic Portosystemic shunt (TIPS).
- Interventional Pain Management Procedures.
IR can play many roles in the diagnosis and treatment of cancer or in the management of certain side effects of cancer and its treatment. Talk to your oncology team about how an Interventional Radiologist may play a role in your care.
Arnold, M.J., & Keung, J.J. (2019). American Family Physician. Interventional Radiology: Indications and Best Practices. May 1;99(9):547-556.
Geschwind, J. F. H., & Soulen, M. C. (2016). Interventional Oncology: Principles and Practice of Image-Guided Cancer Therapy. Cambridge University Press.