Recent Developments and Future Directions in Image-Guided Chemistry

Transcatheter embolotherapies have undergone tremendous evolution and development since the initial reports 5 decades ago. Imaging has likewise advanced with the advent and refinement of computed tomography (CT) and magnetic resonance (MR) imaging. Despite these technical improvements, viable tumor is found in the majority of embolotherapy treated tumors examined under the microscope. Thermoembolization is a novel approach under development that uses in vivo chemistry to address this problem. Relying on basic chemical principles of reactivity, exciting possibilities are emerging for more effective treatments. Furthermore, the serendipitous discovery of unexpected chemical reactions has pointed to a new area of investigation. The authors introduce a unique paradigm, expanding targeted, image-guided in vivo chemistry beyond initial destructive interventions to nondestructive ones, particularly protein modifications. An entirely new world of opportunities is opening for collaboration between interventional radiologists, chemists, and molecular biologists.