Interventional Radiology - Oncological
Did you know that interventional radiologists also play a key role in cancer treatment? This module offers a clear, practical overview of the most important oncological procedures. Discover the impact of this rapidly evolving field.
Introduction
Interventional radiology (IR) is a rapidly growing medical specialty focused on minimally invasive, image-guided treatments. While interventional radiologists were traditionally best known for diagnostic procedures and vascular interventions, IR now plays an increasingly important role in oncological care.
Interventional radiologists treat tumors locally and in a targeted manner, often as an alternative or complement to surgery, systemic therapy (chemotherapy, immunotherapy), and external beam radiotherapy (Fig. 1). Increasingly, academic centers have specialized oncological IR outpatient clinics, where patients are followed and treated longitudinally.
Due to an aging population, improved imaging techniques, and a growing preference for organ- and function-preserving therapies, the role of minimally invasive oncological treatments is expected to continue to expand in the coming years.
The interventional radiologist:
- Treats tumors locally, in a targeted and minimally invasive way
- Works closely with the multidisciplinary oncology team
- Plays an increasingly important role in both curative and palliative care
A clear example of the growing role of IR in oncology is its use in treating hepatocellular carcinoma (HCC). Interventional radiologists are now an indispensable part of the multidisciplinary HCC team, with treatments such as ablation and transarterial techniques. Closely related to this is diagnostics: the LI-RADS classification system categorizes liver lesions in at-risk patients based on radiological features, thereby largely determining subsequent treatment strategy — including the use of interventional radiology.
Despite the rapid growth of the field, oncological IR is still insufficiently known among many healthcare professionals. Physicians, residents, nurses, and other (para)medical staff are often unaware of the treatment options IR offers — and therefore miss opportunities to refer patients promptly or to collaborate in a multidisciplinary setting. This module provides a practical and accessible overview of the possibilities within oncological IR, with clear explanations and illustrative examples from clinical practice. Whether you are a student, in specialist training, or have been working in healthcare for years, this is your opportunity to bring your knowledge of oncological IR fully up to date in one go — practical, structured, and directly applicable.
KEY TOPICS/TERMS IN THE MODULE:
- Image-guided tumor ablation
- Radiofrequency ablation (RFA)
- Microwave ablation (MWA)
- Cryoablation
- Hydrodissection
- Transarterial chemoembolization (TACE)
- Transarterial radioembolization (TARE)
- Selective Internal Radiation Therapy (SIRT)
- 99mTc-MAA scan scintigraphy
- Yttrium-90 (90Y) loaded microspheres
- Lung shunting
- Follow-up after tumor ablation
- Digital subtraction angiography (DSA)
- Indications/contraindications/risks of tumor ablation
- Ablation zone
- Palliative interventions
- Multidisciplinary team meeting (MDT)
- Hepatocellular carcinoma (HCC)
- Barcelona Clinic Liver Cancer (BCLC) classification
- Performance status (PS)
- Liver function (Child-Pugh)
- Liver Imaging Reporting and Data System (LI-RADS)
- LI-RADS Treatment Response classification (viable vs. non-viable)
- 5 major features of HCC
- Non-rim arterial phase hyperenhancement (nr-APHE)
- Washout
- Diffusion restriction
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Text
drs. A. van der Plas (MSK radiologist Maastricht UMC+)
With special thanks to:
drs. T.J.G.R. De Clercq (interventional radiologist Maastricht UMC+)
dr. R.L. Miclea (abdominal radiologist Maastricht UMC+)
Illustrations
drs. A. van der Plas (MSK radiologist Maastricht UMC+)
Sources
- American College of Radiology. (2024). LI-RADS® CT/MRI nonradiation treatment response algorithm (TRA) v2024 core.
- Bex, A., Abu Ghanem, Y., Albiges, L., Bonn, S., Campi, R., Capitanio, U., Dabestani, S., Hora, M., Klatte, T., Kuusk, T., Lund, L., Marconi, L., Palumbo, C., Pignot, G., Powles, T., Schouten, N., Tran, M., Volpe, A., & Bedke, J. (2025). European Association of Urology guidelines on renal cell carcinoma: The 2025 update. European Urology, 87, 683–696.
- Delli Pizzi, A., Mastrodicasa, D., Cianci, R., Serafini, F. L., Mincuzzi, E., Di Fabio, F., Giammarino, A., Mannetta, G., Basilico, R., & Caulo, M. (2020). Multimodality imaging of hepatocellular carcinoma: From diagnosis to treatment response assessment in everyday clinical practice. Canadian Association of Radiologists Journal.
- Elsayed, M., & Solomon, S. B. (2023). Interventional oncology: 2043 and beyond. Radiology, 308(1), e230139.
- Fallahi, M. S., Maroufi, S. F., Maroufi, S. P., Khorasanizadeh, M., Monteiro de Macêdo Filho, L. J., Margetis, K., Guha, D., Tatsui, C. E., & Mansouri, A. (2025). Percutaneous cryoablation in the management of spinal metastases: A comprehensive systematic review and meta-analysis. Journal of Neuro-Oncology, 174, 303–314.
- Hinshaw, J. L., Lubner, M. G., Ziemlewicz, T. J., Lee, F. T., & Brace, C. L. (2014). Percutaneous tumor ablation tools: Microwave, radiofrequency, or cryoablation—What should you use and why? RadioGraphics, 34, 1344–1362.
- Huang, Q., Pang, M., Zeng, Q., He, X., Zheng, R., Ge, M., & Li, K. (2022). The frequency and risk factors of major complications after thermal ablation of liver tumours in 2,084 ablation sessions. Frontiers in Surgery, 9, 1010043.
- Hyun, D. (2025). Transarterial radioembolization for hepatocellular carcinoma in Korea: Current clinical practices, facility requirements, and patient selection. Journal of the Korean Society of Radiology, 86, 447–456.
- Kalil, J. A., Deschenes, M., Perrier, H., Zlotnik, O., & Metrakos, P. (2024). Navigating complex challenges: Preoperative assessment and surgical strategies for liver resection in patients with fibrosis or cirrhosis. Biomedicines, 12, 1264.
- Lanza, C., Ascenti, V., Amato, G. V., Pellegrino, G., Triggiani, S., Tintori, J., Intrieri, C., Angileri, S. A., Biondetti, P., Carriero, S., Torcia, P., Ierardi, A. M., & Carrafiello, G. (2025). All you need to know about TACE: A comprehensive review of indications, techniques, efficacy, limits, and technical advancement. Journal of Clinical Medicine, 14, 314.
- Lee, S., Kim, Y.-Y., Shin, J., Son, W. J., Roh, Y. H., Choi, J.-Y., Sirlin, C. B., & Chernyak, V. (2023). Percentages of hepatocellular carcinoma in LI-RADS categories with CT and MRI: A systematic review and meta-analysis. Radiology.
- Maas, M., Beets-Tan, R., Gaubert, J.-Y., Gomez Munoz, F., Habert, P., Klompenhouwer, L. G., Vilares Morgado, P., Schaefer, N., Cornelis, F. H., Solomon, S. B., van der Reijd, D., & Bilbao, J. I. (2020). Follow-up after radiological intervention in oncology: ECIO-ESOI evidence and consensus-based recommendations for clinical practice. Insights into Imaging, 11, 83.
- Müller, L., Stoehr, F., Mähringer-Kunz, A., Hahn, F., Weinmann, A., & Kloeckner, R. (2021). Current strategies to identify patients that will benefit from TACE treatment and future directions: A practical step-by-step guide. Journal of Hepatocellular Carcinoma, 8, 403–419.
- Nakagomi, R., Tateishi, R., Mikami, S., Wake, T., Nishibatake Kinoshita, M., Nakatsuka, T., Minami, T., Sato, M., Uchino, K., Enooku, K., Nakagawa, H., Asaoka, Y., Shiina, S., & Koike, K. (2021). Infectious complications related to radiofrequency ablation of liver tumors: The role of antibiotics. PLOS ONE, 16(11), e0259641.
- Ni, Y., Mulier, S., Miao, Y., Michel, L., & Marchal, G. (2005). A review of the general aspects of radiofrequency ablation. Abdominal Imaging, 30, 381–400.
- Páez-Carpio, A., Gómez, F. M., Isus Olivé, G., Paredes, P., Baetens, T., Carrero, E., Sánchez, M., & Vollmer, I. (2021). Image-guided percutaneous ablation for the treatment of lung malignancies: Current state of the art. Insights into Imaging, 12, 57.
- Pal, K., Awad, A., Yevich, S., Kuban, J. D., Tam, A. L., Huang, S. Y., Odisio, B. C., Gupta, S., Habibollahi, P., Bishop, A. J., Conley, A. P., Somaiah, N., Araujo, D., Zarzour, M. A., Roland, C. L., Keung, E. Z., & Sheth, R. A. (2024). Safety and efficacy of percutaneous cryoablation for recurrent or metastatic soft-tissue sarcoma in adult patients. American Journal of Roentgenology.
- Park, B. K. (2024). Assessment of local tumor progression after image-guided thermal ablation for renal cell carcinoma. Korean Journal of Radiology, 25(1), 33–42.
- Simon, C. J., Dupuy, D. E., & Mayo-Smith, W. W. (2005). Microwave ablation: Principles and applications. RadioGraphics, 25, S69–S83.
- Wah, T. M., Irving, H. C., Gregory, W., Cartledge, J., Joyce, A. D., & Selby, P. J. (2014). Radiofrequency ablation of renal cell carcinoma (RCC): Experience in 200 tumours. BJU International, 113, 416–428.
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