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Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion

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Image-Guided Approaches for Management of Obesity in Interventional Radiology.

Arun Kamireddy¹, Mohammad Mirza Aghazadeh Attari¹, Dara L Kraitchman¹

¹Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

Journal of Vascular and Interventional Radiology : JVIR

|November 23, 2025

Summary

Minimally invasive, image-guided procedures offer new obesity treatments by targeting appetite regulation. These interventional radiology techniques may enhance weight loss and reduce medication needs.

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Area of Science:

Interventional Radiology
Obesity Management
Medical Technology

Background:

Obesity affects over 40% of US adults, increasing risks for diabetes, cardiovascular disease, and mental health issues.
Traditional obesity treatments like lifestyle changes and bariatric surgery have limitations including access, cost, and risks.
There is a growing need for less invasive, image-guided alternatives for obesity management.

Purpose of the Study:

To review recent advances in interventional radiology-based strategies for obesity management.
To highlight techniques such as bariatric artery embolization (BAE), bariatric arterial radioembolization (BARE), and MRI-guided vagal cryoablation.
To explore the potential of these methods in multimodal, personalized obesity care.

Main Methods:

Focus on bariatric artery embolization (BAE) and bariatric arterial radioembolization (BARE).
Discussion of MRI-guided vagal cryoablation.
Review of peripheral mechanisms including ghrelin suppression and vagal input modulation.

Main Results:

These image-guided interventions modulate appetite peripherally.
Potential for synergistic effects when combined with anti-obesity medications (AOMs).
May serve as rapid, organ-sparing preoperative optimization strategies for patients needing surgery.

Conclusions:

Image-guided interventions represent a shift towards personalized, multimodal obesity care.
Integration into care pathways may expand treatment options and improve outcomes.
These techniques offer potential benefits in enhancing weight loss durability and reducing medication burden.