Interventional Radiology in the Diagnosis of Cancer
Appropriate treatment of malignancy is dependent on a timely definitive diagnosis and on accurate staging of disease. While non-invasive imaging techniques have improved assessment and staging for cancer, histologic confirmation remains the gold standard for definitive diagnosis of many tumours. Biopsies to establish histological diagnosis are increasingly performed using minimally invasive techniques by interventional radiologists.
Interventional Radiology in the Treatment of Cancer
Thermal ablation
A needle based non-surgical day care procedure done under local anesthesia / intra-venous sedation to destroy / kill tumor cells preciously salvaging surrounding healthy organs. These ablation procedures are useful in treating tumors of liver, kidney, lung, bones etc.Trans arterial embolization of bleeding from tumours done to control bleeding successfully.
Trans arterial chemo-embolization
Trans arterial chemo-embolization for large liver cancer has now become the gold standard procedure in intermediate stage of liver cancer. This is an angiographic based procedure under local anesthesia where the specialized medicines are injected directly inside the liver tumor and killing the tumor cells without having any significant side effects in rest of the non-cancerous liver tissue and rest of the body.
Chemo port insertion
Chemo port insertion is an integral part of the care of cancer patients for long term vascular access for the injection of chemotherapeutic agents without the need for repeated punctures.
Percutaneous trans hepatic biliary drainage & stenting
Percutaneous trans hepatic biliary drainage and stenting are successfully performed in patients presenting with progressive jaundice and severe itching due to malignant biliary obstruction caused by either gall bladder/ bile duct cancer or pancreatic head cancer.
Biliary decompression can reduce the bilirubin level and enable patients to accept the chemotherapeutic drugs.
Interventional Radiology in the Management of the Complications of Cancer
Malignancy can induce dysfunction of many organs and bodily systems. Though debilitating, a significant portion of these complications are reversible, many by minimally invasive IR methods. Such treatment can relieve symptoms, alleviate pain, and improve operability of patients, thus having a significant positive impact on quality of life.
Biliary Obstruction
The majority of patients presenting with malignant biliary obstruction have an underlying pancreatic neoplasm extrinsically compressing the distal bile duct and can be treated by endoscopic means. Metastatic disease at the hepatic hilar nodes or in the peripancreatic nodes may cause obstructive jaundice from extrinsic pressure on the proximal portions of the biliary tree and may require percutaneous intervention if less invasive endoscopic means fails to achieve adequate biliary decompression. Contrast injection into an intra-hepatic bile duct at percutaneous transhepatic cholangiography will delineate the anatomy of the biliary tree, determining the location of obstruction, and helping to guide intervention. Percutaneous transhepatic biliary drainage (PBD) is an effective method for the primary or palliative management of many biliary abnormalities demonstrated with cholangiography. This procedure involves selective cannulation of the biliary tree with catheter manipulation, then placement of a catheter or stent to facilitate internal or external drainage of biliary flow and so allow decompression of the biliary system .