[Interventional Radiology in Oncology - Update 2021]

Interventional radiology plays a crucial role in oncology. The most common interventional treatments are transarterial embolisation as well as percutaneous thermal ablations. Transarterial embolisation, such as transarterial chemoembolization (TACE) or selective internal radiation therapy (SIRT) are well established, usually palliatively intended treatment options for primary and secondary hepatic malignancies. Embolisation is usually well tolerated under conscious sedation and can be repeated several times. Percutaneous thermoablation is a local ablative, usually curatively intended treatment for hepatic, renal and pulmonary tumors. As a minimally invasive technique, it competes against surgery and radiation therapy. There are different types of thermoablation, most commonly used are radiofrequency ablation (RFA), microwave ablation (MWA) and cryo-ablation. Ablation is usually performed in general anesthesia, less common in conscious sedation. New interventional treatments are high intensity focused ultrasound (HIFU) and irreversible electroporation (IRE). HIFU allows a non-invasive, imaging-guided thermoablation that is currently certified for uterine myoma, prostate cancer and bone tumors. IRE is a minimal invasive non-thermal ablation that is especially established for locally advanced tumors that show a close relationship to large vessels, for example pancreatic cancer.