Interventional Radiology

Overview

Procedures Performed

I. NON-VASCULAR INTERVENTIONAL RADIOLOGY

A. PERCUTANEOUS BIOPSY

Tissue and cell samples can be obtained from various organs using specialized needles under ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) guidance. These procedures are generally performed under local anesthesia, and patients are usually discharged the following day, depending on the procedure and their clinical condition.

1. Percutaneous Liver Biopsy

Liver biopsy is performed primarily for two purposes. The first is to evaluate the activity and severity of diffuse liver diseases, such as Hepatitis B and C, alcoholic hepatitis, drug-induced liver injury, and disorders involving iron or copper accumulation. The second is to establish a definitive diagnosis of a suspected liver tumor.

The procedure is usually performed under ultrasound guidance and local anesthesia. Following the biopsy, patients are monitored due to the risk of delayed bleeding.

2. Percutaneous Kidney Mass Biopsy

Percutaneous kidney biopsy involves obtaining a small tissue sample from the kidney parenchyma or a suspected renal mass using a biopsy needle under ultrasound guidance.

The procedure is performed with the patient in the prone position under local anesthesia. Patients generally experience minimal discomfort and are usually discharged the following day.

3. Percutaneous Lung Biopsy

Lung biopsy involves obtaining a small tissue sample from a mass within the lung or from surrounding lymph nodes. It is generally performed to establish the diagnosis of a suspected lesion.

The procedure is performed under CT guidance after local anesthesia is administered to the entry site. Patients are usually discharged the following day, depending on their clinical condition.

4. Thyroid Biopsy

Thyroid biopsy is performed when thyroid nodules exhibit suspicious features that may indicate a risk of malignancy. The procedure is generally performed using fine-needle aspiration (FNA) under ultrasound guidance.

The collected cellular material is often sufficient for diagnostic evaluation. Patients can usually be discharged shortly after the procedure, with no significant activity restrictions in most cases.

5. Pancreatic Biopsy

Pancreatic biopsy is performed in patients with suspected pancreatic tumors to obtain tissue samples for diagnostic evaluation.

The procedure can be performed under CT, ultrasound, or endoscopic ultrasound (EUS) guidance. Depending on the clinical indication, either a fine needle or a core biopsy needle may be used. Patients are usually discharged the following day.

6. Bone Biopsy

Bone biopsy is performed to diagnose various bone diseases and suspected bone tumors. A tissue sample is obtained directly from the affected bone using a specialized biopsy needle.

The entry site is numbed with local anesthesia. The procedure is generally performed under CT guidance and is usually completed within a short time. Patients are discharged after an appropriate observation period.

7. Biopsies of Other Organs and Tissues

Similar image-guided biopsy procedures can also be performed to evaluate suspicious lesions involving:

- Intra-abdominal masses, including splenic, intestinal, and peritoneal lesions
- Neck masses, including parotid and salivary gland tumors
- Soft tissue and muscle tumors

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B. DRAINAGE PROCEDURES (ULTRASOUND- OR CT-GUIDED)

Drainage is a minimally invasive procedure used to remove abscesses (infected fluid collections) and accumulated fluids from different parts of the body without the need for open surgery.

Interventional radiologists identify the location of abscesses or fluid collections using ultrasound or computed tomography (CT) guidance. A drainage catheter, which is a thin and flexible plastic tube, is then inserted through the skin into the affected area under image guidance and local anesthesia.

The accumulated or infected fluid is drained through the catheter. The catheter may remain in place for several days and is removed once the collection has resolved or the infection has been adequately controlled.

These minimally invasive techniques can be used to treat abscesses and fluid collections involving the liver, spleen, kidneys, abdominal cavity, and thoracic cavity, as well as postoperative fluid leaks and collections.

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C. BILIARY TRACT INTERVENTIONS

1. Biliary Drainage, Stent Placement, and Balloon Dilatation Procedures

Biliary drainage, stent placement, and balloon dilatation procedures are performed to restore bile flow and prevent complications associated with bile duct obstruction or bile leakage.

Under normal conditions, bile produced by the liver flows through the bile ducts into the intestine, where it contributes to the digestion and absorption of fats. When the bile ducts become obstructed or bile leakage occurs, the normal flow of bile is disrupted. This can lead to jaundice, severe abdominal pain, infection, and potentially life-threatening complications.

Interventional radiology techniques help restore normal bile flow, relieve obstruction, and manage bile leakage through minimally invasive procedures, often avoiding the need for open surgery.