Awareness of Radiologists and Radiographers toward Patient Care in the Interventional Radiology Department

Background: The hospitals and health care centres are organized around the patient, a model in which healthcare providers partner with patients and families to identify and satisfy patients’ needs and preferences. Providers respect patients’ values and preferences, address their emotional and social needs, and involve them and their families in decision making. According to the best of our knowledge, there is no evidence to prove, radiologists and radiographers are aware enough about the patient safety, care, and code of conduct with their patients in the interventional radiology department. Objective: This article aims to measure the awareness of radiologists and radiographers toward care and safety in an interventional radiology department. Material and Method: This study was carried in period from 15 February to 20 April 2022. One hundred sixty-four radiographers and radiologists participating in this study completed the questionnaire, which equals a response rate of approximately 82%. The questionnaire was fully completed by almost all responders;only a few of them gave partial answers. Results: The first question for radiographers and radiologists was “the sufficient awareness about the patient safety and care during the interventional radiology procedure. Also, the majority of the radiographers and radiologists are providing the patients with sufficient information when he/she ask for help or queries. A large number of radiographers and radiologists were participating in this study explaining the procedures to patients before starting the examinations in a structured way. Finally, the result shows both radiographers and radiologists respect the patient’s rights, privacy, and dignity and also kept the radiation protection during the interventional radiology procedures. Conclusion: This article summarizes the key categories of awareness of patient care issues in the provision of interventional radiology services, from the joint perspectives of radiographers and radiologists, and provides references for further reading in all major relevant areas.

Precision interventional radiology

The recent interest in precision medicine among interventionists has led to the establishment of the concept of precision interventional radiology(PIR).This concept focuses not only on the accuracy of interventional operations using traditional image-guided techniques,but also on the comprehensive evaluation of diseases.The invisible features extracted from CT,MRI,or US improve the accuracy and specificity of diagnosis.The integration of multi-omics and molecule imaging provides more information for interventional operations.The development and application of drugs,embolic materials,and devices broaden the concept of PIR.Integrating medicine and engineering brings new image-guided techniques that increase the efficacy of interventional operations while reducing the complications of interventional treatment.In all,PIR,an important part of precision medicine,emphasizing the whole disease management process,including precision diagnosis,comprehensive evaluation,and interventional therapy,maximizes the benefits of patients with limited damage.

Interventional radiology treatment for pulmonary embolism

Venous thromboembolism(VTE) is an illness that has a potentially life-threatening condition that affects a large percentage of the global population. VTE with pulmonary embolism(PE) is the third leading cause of death after myocardial infarction and stroke. In the first three months after an acute PE, there is an estimated 15% mortality among submassive PE, and 68% mortality in massive PE. Current guidelines suggest fibrinolytic therapy regarding the clinical severity, however some studies suggest a more aggressive treatment approach. This review will summarize the available endovascular treatments and the different techniques with its indications and outcomes.

The Role of Interventional Radiology in Splenic Trauma

The purpose of this case report is to discuss the different treatment options available in splenic trauma patients by following the story of Mr. H. I will focus particularly on the role of splenic arterial embolisation (SAE)—an interventional radiological procedure—and how it weighs up against its surgical counterparts. In order to give a balanced view this case report includes a literature review around splenic artery embolisation. This report concludes that when managing splenic trauma, interventional radiology (IR) is a useful tool particularly when used in conjunction with surgery. The future of this field needs to allow SAE to become a stand-alone therapy. Furthermore, research needs to investigate which cohorts of patients are best suited to which intervention such that we can capitalise on the advantages of each intervention for the benefit of all.

Interventional Radiology in Côte d’Ivoire: Analysis and Assessment of the Radiological Risk of the Surgical Team

Ionizing radiation is widely used in medical practice for both diagnostic and therapeutic purposes. However, they are not devoid of adverse health effects on exposed operators. Therefore, we propose to assess the radiological risk of the interventional radiology team of the International Polyclinic of Indénié of Abidjan during the procedures of Embolization of uterine fibromyomas. The effective and equivalent doses to the extremities and crystals were estimated by TLD dosimeters positioned at different body areas selected on the basis of a radiological analysis of the exposure of personnel during five procedures. The analysis of fluoroscopic and record times showed variability in or an average fluoroscopy time of 32.37 min with extremes of 25.14 to 56.32 min;average record time of 0.52 min with extremes of 0.12 min to 1 min. The annual effective doses were respectively, 4.04 mSv, 3.42 mSv, 2.84 mSv;2.28 mSv, in the Radiologist (R), Operator Assistant (O2);Anesthesiologist (A2), Manipulator (M2). The annual equivalent doses to the radiologist’s predominant extremities and lenses were left index and left lens with values of 37.07 mSv and 9.46 mSv. The estimated doses in our study are reassuring from a regulatory point of view of dose limits. The results of our work have shown no significant short-term danger to the health of personnel.

Current trends and perspectives in interventional radiology for gastrointestinal cancers

Gastrointestinal(GI)cancers often require a multidisciplinary approach involving surgeons,endoscopists,oncologists,and interventional radiologists to diagnose and treat primitive cancers,metastases,and related complications.In this context,interventional radiology(IR)represents a useful minimally-invasive tool allowing to reach lesions that are not easily approachable with other techniques.In the last years,through the development of new devices,IR has become increasingly relevant in the context of a more comprehensive management of the oncologic patient.Arterial embolization,ablative techniques,and gene therapy represent useful and innovative IR tools in GI cancer treatment.Moreover,IR can be useful for the management of GI cancer-related complications,such as bleeding,abscesses,GI obstructions,and neurological pain.The aim of this study is to show the principal IR techniques for the diagnosis and treatment of GI cancers and related complications,as well as to describe the future perspectives of IR in this oncologic field.

Progress in interventional radiology treatment of pulmonary embolism:A brief review

Pulmonary embolism represents a common life-threatening condition.Prompt identification and treatment of this pathological condition are mandatory.In cases of massive pulmonary embolism and hemodynamic instability or right heart failure,interventional radiology treatment for pulmonary embolism is emerging as an alternative to medical treatment(systemic thrombolysis)and surgical treatment.Interventional radiology techniques include percutaneous endovascular catheter directed therapies as selective thrombolysis and thrombus aspiration,which can prove useful in cases of failure or infeasibility of medical and surgical approaches.

Role of interventional radiology in the management of acute gastrointestinal bleeding

Acute gastrointestinal bleeding(GIB) can lead to significant morbidity and mortality without appropriate treatment. There are numerous causes of acute GIB including but not limited to infection, vascular anomalies, inflammatory diseases, trauma, and malignancy. The diagnostic and therapeutic approach of GIB depends on its location, severity, and etiology. The role of interventional radiology becomes vital in patients whose GIB remains resistant to medical and endoscopic treatment. Radiology offers diagnostic imaging studies and endovascular therapeutic interventions that can be performed promptly and effectively with successful outcomes. Computed tomography angiography and nuclear scintigraphy can localize the source of bleeding and provide essential information for the interventional radiologist to guide therapeutic management with endovascular angiography and transcatheter embolization. This review article provides insight into the essential role of Interventional Radiology in the management of acute GIB.

The Journey of Interventional Radiology in China

The first balloon angioplasty performed by Dr.Charles T.Dotter in 1964 marked the birth of a new discipline in radiology(1),which was initially named'interventional diagnostic radiology'by Dr.Alexander R.Margulis in 1967(2),and later defined as'Interventional Radiology(IR)'by Dr.Sidney Wallace in 1976(3).Along with the wide adaptation of Seldinger’s technique for percutaneous vascular access(4),interventional radiology expanded the horizon of traditional radiology.

Evaluation of CdZnTe spectrometer performance in measuring energy spectra during interventional radiology procedure

Interventional radiology has been beneficial for patients for over 30 years of age with the combination of diagnostic and therapeutic methods. The radiation affecting occupationally exposed workers should be evaluated by means of the energy spectra and flux of X-rays in the treatment room. The present study aims to obtain the energy spectra of interventional procedures and study the capability of some detectors to evaluate the dose in interventional procedures. These measurements were taken by silicon-drift, CdTe, and CdZnTe detectors. The energy spectra were corrected by the energy-response curve of each detector. The energy-response curves of silicon-drift and CdTe detectors provided by the manufacturers specification were used. The energy response of the CdZnTe detector was measured by 133Ba and 152Eu γ sources. The experimental data were compared with the simulation results, and their perfect agreement provides a way to correct the energy or dose response, which can be used for the personal dosimeter developed by our group. Moreover, the measured energy spectra can be used in individual radiation protection. The present study shows that the CdZnTe detector is a good candidate detector in interventional procedures.

100 classic papers of interventional radiology: A citation analysis

AIM: To define the 100 citation classic papers of interventional radiology.METHODS: Using the database of Journal Citation Reports the 40 highest impact factor radiology journals were chosen. From these journals the 100 most cited interventional radiology papers were chosen and analysed.RESULTS: The top paper received 2497 citations and the 100 th paper 200 citations. The average number of citations was 320. Dates of publication ranged from 1953- 2005. Most papers originated in the United States(n = 67) followed by Italy(n = 20) and France(n = 10). Harvard University(n = 18) and Osped Civile(n = 11) were the most prolific institutions. Ten journals produced all of the top 100 papers with "Radiology" and "AJR" making up the majority. SN Goldberg and T Livraghi were the most prolific authors. Nearly two thirds of the papers(n = 61) were published after 1990.CONCLUSION: This analysis identifies many of the landmark interventional radiology papers and provides a fascinating insight into the changing discourse within the field. It also identifies topics, authors and institutions which have impacted greatly on the specialty.

Complementary roles of interventional radiology and therapeutic endoscopy in gastroenterology

Acute upper and lower gastrointestinal bleeding, enteral feeding, cecostomy tubes and luminal strictures are some of the common reasons for gastroenterology service. While surgery was initially considered the main treatment modality, the advent of both therapeutic endoscopy and interventional radiology have resulted in the paradigm shift in the management of these conditions. In this paper, we discuss the patient's work up, indications, and complementary roles of endoscopic and angiographic management in the settings of gastrointestinal bleeding, enteral feeding, cecostomy tube placement and luminal strictures. These conditions often require multidisciplinary approaches involving a team of interventional radiologists, gastroenterologists and surgeons. Further, the authors also aim to describe how the fields of interventional radiology and gastrointestinal endoscopy are overlapping and complementary in the management of these complex conditions.

Poul Erik Andersen's radiological work on osteochondrodysplasias and interventional radiology

Poul Erik Andersen is a Professor and Interventional Radiologist at the University of Southern Denmark,Odense and Odense University Hospital,Denmark.His innovative and expertise is primarily in vascular interventions where he has introduced and developed many procedures at Odense University Hospital.His significant experience and extensive scientific work has led to many posts in the Danish Society of Interventional Radiology,the European Society of Radiology and the Cardiovascular and Interventional Radiological Society of Europe,where he is a fellow and has passed the European Board of Interventional Radiology-The European qualification in Interventional Radiology.

My road on interventional radiology

The author tells a story of how he has become an expert of interventional radiotherapy from a graduate of middle school.In his childhood,he wanted to become an astronomer.However,he was forced to go to the countryside as a school graduate.In 1974,he was enrolled as a"worker-peasant-soldier"student in Henan Medical College.After graduated from the college,he was assigned to the Radiology Department of the First Affiliated Hospital of Henan Medical College where he worked hard as an assistant doctor.Then,he was transferred to Nanfang Hospital(Guangzhou,China) where he achieved great successes and thus has become an expert of interventional radiology.

Takao Hiraki's work on interventional radiology

Dr.Takao Hiraki is a scientist carrying out interventional radiology research in the Department of Radiology at Okayama University Medical School,Japan.He has conducted animal and human clinical studies on interventional radiology for various conditions.For example,he clarified the hepatic hemodynamic changes caused by hepatic venous occlusion.He also developed new devices,such as hydrogel coils for the occlusion of the aneurismal sac after an endovascular stent-graft of an aortic aneurysm to prevent endoleakage and small intestinal submucosa-covered stents for transjugular intrahepatic portosystemic shunts.Further,he performed a number of studies on the radiofrequency ablation of lung cancer,mediastinal lymph node metastasis,and computed tomography-fluoroscopy-guided lung biopsies.He intends to continue to dedicate his academic career to expand the role of interventional radiology in clinical medicine.

Utility and efficacy of navigation system use in interventional radiology

Background: To ensure precision and accuracy during interventional radiologic (IR) procedures, navigation systems are utilized. There are four main categories of guidance systems that can be used to assist in IR procedures: optical system, electromagnetic (EM) tracking, Cone Bean Computer Tomography (CBCT) and Magnetic Navigation system. Objective: The purpose of this report is to examine some current medical literature to present an impression as to the state of navigation system use in interventional radiology. Methods: Three health databases were selected: Pubmed, Embase and OVID Medline, with the search terms “Interventional Radiology” and “Navigation System” being used. All included studies were presented in English. Studies were excluded if they did not pertain to navigation systems in interventional radiology, were in a language other than English, presented an abstract only or solely discussed interventional cardiology. Results: General themes emerged within the literature for the advantages of navigation system use including benefits to interventional radiologic procedures, increased patient accuracy and reduced procedure time and the potential for reduction in costs. Increased radiation exposure, problems accounting for respiratory motion and sterility remain issues for navigation system use. Conclusion: With potential to better standardize treatment using navigation systems, patients can have access to up-to-date technology for treatment. To ensure the highest standard of care, navigation systems should be used by interventional radiologists only. As indications and clinical efficacy are frequently being defined for navigation system use in interventional radiology, continual review of the published literature and large clinical trials for each system should be pursued.

Variability in Fluoroscopic Time during Interventional Non-Cardiac Procedures Performed Outside of the Radiology Department

Purpose: Increasing physician awareness of patient exposure to radiation is an important step towards the reduction of potentially harmful effects of radiation. Published studies demonstrated that providing physicians with feedback regarding their fluoroscopy time leads to a reduction in average fluoroscopy times. The aim of this work was to analyze and publish our medical center data observed during the past year;fluoroscopy time (FT), Dose Area Product (DAP) and cumulative dose (CD) were monitored for radiation protection purposes. Methods: Fluoroscopy time is one of multiple radiation dose indices used in radiation safety auditing. Such auditing is nowadays turning into requirement of patient care safety and quality improvement;as indicated by accreditation bodies both nationally and internationally. All non-cardiac procedures performed outside radiology department by surgeons and interventionists are viewed. FT, DAP and CD are extracted for analysis. Results: a total of 846 cases were studied (643 orthopedic, 99 others, 73 urology, 17 chest, 7 vascular and 4 ERCP cases). Mean FT was 1.3 minutes, mean CD to the patient was 12.98 mGy and the mean DAP was 4.53 Gy/cm2. The longest FT noted was 55 min. The maximum CD was 904 mGy and the maximum DAP was 689 Gy/cm2. Using spearman’s correlation test we found out that there is a significant correlation between FT and DAP (correlation coefficient = 0.615, p. value 0.001). There is a significant correlation between FT and CD (correlation coefficient = 0.628, p. value 0.001). Conclusion: Information about FT that used in each procedure can be used as a tool for patient dose optimization. As we found a significant correlation between DAP as well as CD. Reducing fluoroscopic time (FT) is a radiation protection goal, since it serves the purpose of protection for both the patient and the workers.

Interventional Radiology Procedures after Pediatric Pyeloplasty and Ureteral Reimplantation in Patients with Postoperative Obstruction

Introduction: Obstructive complication after pyeloplasty or ureteral reimplant surgery is a rare though worrisome problem in pediatric urology. These are often complex patients with complicated post-operative courses that at times require interventional radiology procedures. The current literature is lacking in guiding principles to manage these complications. In this study we have reviewed these difficult to manage patients at our children’s hospital over the past 15 years. Methods: A list of patients who underwent interventional radiology procedures to place nephrostomy tubes or internal double-J ureteral stents was compared a list of patients undergoing pyeloplasty or reimplant procedures. These lists were cross-referenced to a list of patients undergoing cystoscopic removal of double-J stents. This small patient group does not represent all complications but those with radiology intervention. Results: At our institution, during the years 1998-2011 we performed 458 pyeloplasties and 3003 open ureteral reimplant procedures. 14 (0.4%) met all of the inclusion criteria. The long term outcome of these problems showed 11 of these patients went on to stability or improvement with either percutaneous drainage or JJ stent placement alone, and three of the reimplant patients ultimately required redo surgery. Of our pyeloplasty patients only three required percutaneous nephrostomy tube, and one went on to JJ stent placement (0.66% of pyeloplasties). No patients in the pyeloplasty group needed surgical revision. Of patients how had undergone ureteral reimplantation, with or without tapering, seven of them underwent interventional radiology procedures (0.23% of reimplant patients). Conclusion: Pediatric urology patients with persistent obstruction after pyeloplasties and ureteral reimplantation surgery with or without tapering who needed interventional radiology rescue procedure resolved or stabilized in 11 of 14 patients. Surgical revision was performed in only 3 of our 14 patients after months of conservative trial after interventional radiologic procedures.

Interventional radiology followed by endoscopic drainage for pancreatic fluid collections associated with high bleeding risk: Two case reports

BACKGROUND Endoscopic ultrasound(EUS)-guided transluminal drainage is an advanced technique used to treat pancreatic fluid collections(PFCs). However, gastric varices and intervening vessels may be associated with a high risk of bleeding and are, therefore, listed as relative contraindications. Herein, we report two patients who underwent interventional embolization before EUS-guided drainage.CASE SUMMARY Two 32-year-old males developed symptomatic PFCs after acute pancreatitis and came to our hospital for further treatment. One patient suffered from intermittent abdominal pain and vomiting, and computed tomography(CT) imaging showed an encapsulated cyst 7.93 cm × 6.13 cm in size. The other patient complained of a mass inside the abdomen, which gradually became enlarged. Gastric varices around the ideal puncture site were detected by EUS when we evaluated the possibility of endoscopic drainage in both patients. Interventional embolization was recommended as the first procedure to decrease the risk of bleeding. After that, EUS-guided transluminal drainage was successfully conducted, without vascular rupture. No postoperative complications occurred during hospitalization, and no recurrence was detected at the last follow-up CT scan performed at 1 mo.CONCLUSION Interventional embolization is a safe, preoperative procedure that is performed before EUS-guided drainage in PFC patients with gastric varices or at high risk of bleeding.

Successful treatment of complex cholangiolithiasis following orthotopic liver transplantation with interventional radiology

Bile duct stones are a serious and the third most common complication of the biliary system that can occur following liver transplantation.The incidence rate of bile duct stones after liver transplantation is1.8%-18%.The management of biliary stones is usually performed with endoscopic techniques;however,the technique may prove to be challenging in the treatment of the intrahepatic bile duct stones.We herein reporta case of a 40-year-old man with rare,complex bile duct stones that were successfully eliminated with percutaneous interventional techniques.The complex bile duct stones were defined as a large number of bile stones filling the intra-and extrahepatic bile tracts,resulting in a cast formation within the biliary tree.Common complications such as hemobilia and acute pancreatitis were not present during the perioperative period.The follow-up period was 20 mo long.During the postoperative period,the patient maintained normal temperature,and normal total bilirubin and direct bilirubin levels.The patient is now living a high quality life.This case report highlights the safety and efficacy of the percutaneous interventional approach in the removal of complex bile duct stones following liver transplantation.