Vaskulárna medicína 2/2020

Interventional radiology procedures in diagnostics and treatment of oncological diseases

Interventional radiology today offers a wide range of interventions in the area of diagnostics as well as treatment of oncological diseases. Diagnostic tissue biopsies from tumorous processes are performed depending on their location using relevant imaging technology, usually ultrasound or CT guidance. With some patients this is the first step leading up to suitable oncological or surgical treatment based on results from histology exam. What is an absolute must, however, is sufficient and professional technical equipment as well as trained and skilled personnel. These prerequisites allow for standardization of individual procedures and adherence to recognized interventional radiology societies “evidence based medicine” processes. This in turn decreases the morbidity and mortality during individual interventions and speeds up the therapeutic process. In the first part of the article the authors go into great detail describing the methodology of taking a tissue sample from specific locations in the area of chest, the abdomen and the pelvis, continuing with safety and the extent of possible complications during the interventions themselves. Second part of the article then focuses on therapeutic interventional procedures, their success rate, safety and complications as described in the currently available literature. Ablation techniques of primary and metastatic tumors in radical as well as palliative intentions are further on described individually. Discussions afterwards focus on management of complications, which go hand in hand with known tumor process such as urostasis, bile ducts dilatation and management of refractory ascites and pleural effusion.

Keywords: interventional radiology, ablation techniques, bioptic techniques, skiascopy, nephrostomia, percutaneous transhepatic drainage, indwelling catheter