Using minimally invasive imaging-guided procedures to diagnose and treat diseases in solid abdominal neolpasias, as well as in nearly every organ system, is one of the prerequisite of interventional oncology, a medical sub-speciality interventional radiology.
The diagnosis of solid abdominal neoplasias is usually made by minimally invasive procedures, for example Computed Tomography (CT), Magnetic Resonanace Imaging (MRI) and Position Emission Tomography- Computed Tomography (PET-CT), with varying degrees of accuracy. The diagnosis can be confirmed and complemented by a transcutaneous injection (biopsy). At the same time, a correct needle placement is confirmed by imaging techniques, such as ultrasounds and CT, since they are radiological procedures.
Well-established techniques can be broadly categorized into percutaneous and endovascular ones:
Percutaneous techniques: thermoablation is a regional therapy for the treatment of primary and secondary metastatic liver and kidney tumors mainly represented by Radiofrequency Ablation (RFA) and Microwave Ablation (MWA), two local-tumor ablative therapies. Percutaneous techniques are performed using imaging techniques, such as CT and ultrasounds, so as to check if the needle is well-positioned.
On the other hand, among the most common endovascular techniques, hepatic chemoembolization (HACE) and embolization (HAE) are the first line treatments for liver malignancies. In particular, through transarterial chemoembolization and transarterial embolization a selective occlusion of the tumor arterial blood supply with a variety of embolizing agents results in an anti-tumor desvacularization and necrosis, accompanied by a reduction in size. The use of TAC within the angiographic room ensures the procedure’s extreme accuracy.
Among other treatment options which can be performed where traditional procedures have failed there are, for example, portal vein embolization before liver resection or port catheter implantation for patients with primary liver cancer.
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