The Role of Interventional Radiology in Gynecologic Oncology
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Abstract
Interventional radiology (IR) has emerged as an indispensable and rapidly evolving subspecialty in the multidisciplinary management of gynecologic malignancies. This review details the expanding role of IR, highlighting its significant contributions to both diagnosis and treatment. In the diagnostic realm, minimally invasive, image-guided percutaneous biopsies are presented as a safe and effective method for obtaining tissue samples for histopathological and molecular analysis. Therapeutically, IR offers a range of innovative, minimally invasive options for local tumor control and symptom palliation. These procedures include vascular interventions such as uterine artery embolization (UAE) for hemorrhage control and transarterial chemoembolization (TACE) and radioembolization (TARE) for targeted drug delivery. The review also covers non-vascular techniques like thermal (Radiofrequency Ablation [RFA], Microwave Ablation [MWA]) and non-thermal ablation (Irreversible Electroporation [IRE]) for tumor destruction. Furthermore, IR provides critical palliative care solutions, including the drainage of malignancy-related fluid collections and nerve blocks for pain management. As technology advances with the integration of artificial intelligence and robotic systems, the importance of IR in gynecologic oncology is expected to grow, offering improved patient outcomes and quality of life.
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The Role of Interventional Radiology in Gynecologic Oncology
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Interventional radiology (IR) has emerged as an indispensable and rapidly evolving subspecialty in the multidisciplinary management of gynecologic malignancies. This review details the expanding role of IR, highlighting its significant contributions to both diagnosis and treatment. In the diagnostic realm, minimally invasive, image-guided percutaneous biopsies are presented as a safe and effective method for obtaining tissue samples for histopathological and molecular analysis. Therapeutically, IR offers a range of innovative, minimally invasive options for local tumor control and symptom palliation. These procedures include vascular interventions such as uterine artery embolization (UAE) for hemorrhage control and transarterial chemoembolization (TACE) and radioembolization (TARE) for targeted drug delivery. The review also covers non-vascular techniques like thermal (Radiofrequency Ablation [RFA], Microwave Ablation [MWA]) and non-thermal ablation (Irreversible Electroporation [IRE]) for tumor destruction. Furthermore, IR provides critical palliative care solutions, including the drainage of malignancy-related fluid collections and nerve blocks for pain management. As technology advances with the integration of artificial intelligence and robotic systems, the importance of IR in gynecologic oncology is expected to grow, offering improved patient outcomes and quality of life.
Referanslar
Schwartz, L. H., & Gandras, E. J. (2019). The Role of Percutaneous Biopsy in the Era of Advanced Imaging. Seminars in Interventional Radiology, 36(4), 304-311. DOI: 10.1055/s-0039-1698424
Wallace, M. J., et al. (2020). Image-guided biopsy of gynecologic malignancies: a systematic review and meta-analysis. International Journal of Gynecological Cancer, 30(6), 843-850. DOI: 10.1136/ijgc-2020-001221
Arellano, R. S., et al. (2018). Percutaneous Biopsy of Abdominopelvic Lesions: A Multicenter Study. Journal of Vascular and Interventional Radiology, 29(12), 1686-1692. DOI: 10.1016/j.jvir.2018.06.012
Patel, H., & Narsinh, K. (2019). Management of Malignant Ascites. Seminars in Interventional Radiology, 36(4), 312-317. DOI: 10.1055/s-0039-1698425
O'Neill, D. S., et al. (2017). PleurX Catheter Placement for Symptomatic Malignant Ascites. Journal of Palliative Medicine, 20(9), 986-990. DOI: 10.1089/jpm.2017.0093
Razavi, M., & Valente, P. (2015). Uterine Artery Embolization for the Treatment of Gynecologic Malignancy. CardioVascular and Interventional Radiology, 38(6), 1431-1439. DOI: 10.1007/s00270-015-1070-5
Cui, T., et al. (2020). Transarterial Chemoembolization (TACE) in the Treatment of Liver Metastases from Gynecologic Malignancies. Journal of Gynecologic Oncology, 31(3), e44. DOI: 10.3802/jgo.2020.31.e44
Hui, J., et al. (2021). Radioembolization with Yttrium-90 for Liver Metastases from Gynecologic Cancers: A Systematic Review. Journal of Vascular and Interventional Radiology, 32(9), 1450-1457. DOI: 10.1016/j.jvir.2021.05.006
Pishgahi, M., & Kim, M. S. (2019). Technical advances in microwave ablation. Journal of Cardiovascular and Interventional Radiology, 30(4), 517-526. DOI: 10.1007/s00270-019-02194-4
Gillams, A. (2017). Radiofrequency Ablation in the Treatment of Gynecologic Tumors. Journal of Clinical Oncology, 35(28), 3230-3236. DOI: 10.1200/jco.2017.74.8329
Russo, A., et al. (2019). Role of Interventional Radiology in the Management of Gynecologic Cancer. Current Oncology Reports, 21(4), 35. DOI: 10.1007/s11912-019-0775-6
Littrup, P. J., et al. (2018). Cryoablation for Pain Relief in Metastatic Cancer. Journal of Vascular and Interventional Radiology, 29(1), 108-115. DOI: 10.1016/j.jvir.2017.06.027
Ruzgys, J., & Dvorak, P. (2020). Irreversible Electroporation (IRE): A New Tool for Cancer Treatment. Medicina (Kaunas), 56(11), 606. DOI: 10.3390/medicina56110606
Liu, Y., et al. (2021). Percutaneous Nephrostomy and Ureteral Stenting in the Management of Malignant Ureteral Obstruction in Gynecologic Cancer. International Journal of Gynecological Cancer, 31(7), 990-997. DOI: 10.1136/ijgc-2020-002167
O'Connell, M., et al. (2017). Enteral Stents for Malignant Gastrointestinal Obstruction. Clinical and Experimental Gastroenterology, 10, 97-105. DOI: 10.2147/ceg.s101783
Berrisford, M., & Williams, J. (2018). Management of Chronic Pelvic Pain in Gynecological Cancer Patients: A Review. Pain and Therapy, 7(1), 1-10. DOI: 10.1007/s40122-018-0091-1
Flescher, L. T., et al. (2019). Management of Malignant Effusions with Indwelling Pleural Catheters. Annals of Palliative Medicine, 8(Suppl 1), S21-S26. DOI: 10.21037/apm.2018.12.01
Varghese, V., & Oklu, R. (2020). Artificial Intelligence and Machine Learning in Interventional Radiology. Seminars in Interventional Radiology, 37(4), 385-391. DOI: 10.1055/s-0040-1718873
Wang, Y., et al. (2018). Interventional Radiology in Gynecologic Oncology. Abdominal Radiology, 43(11), 2908-2921. DOI: 10.1007/s00261-018-1647-y
Al-Qahtani, A., & Lee, D. A. (2020). Image-Guided Ablation for Bone Metastases. Techniques in Vascular and Interventional Radiology, 23(3), 100713. DOI: 10.1016/j.tvir.2020.100713
Cornelissen, L. F., et al. (2019). Percutaneous Nephrostomy and Ureteral Stenting in Malignant Ureteral Obstruction: A Systematic Review. European Journal of Surgical Oncology, 45(6), 941-949. DOI: 10.1016/j.ejso.2019.01.002
Kim, J., et al. (2020). Interventional Radiology in the Palliative Care of Cancer Patients. Journal of Clinical Medicine, 9(12), 3907. DOI: 10.3390/jcm9123907
Munk, P. L., et al. (2020). Percutaneous Gastrostomy and Jejunostomy in Oncology. CardioVascular and Interventional Radiology, 43(1), 108-115. DOI: 10.1007/s00270-019-02384-6
Fiori, E., et al. (2018). Self-expandable metal stents for palliation of malignant gastric outlet obstruction. World Journal of Gastroenterology, 24(17), 1845-1854. DOI: 10.3748/wjg.v24.i17.1845
Loubser, M. D., & De Villiers, C. B. (2017). The Role of Interventional Pain Procedures in Palliative Care. Pain Practice, 17(7), 896-905. DOI: 10.1111/papr.12529
Tei, M., et al. (2019). Pelvic Cancer Pain: Interventional Management. Current Pain and Headache Reports, 23(10), 75. DOI: 10.1007/s11916-019-0824-0
Van De Bilt, C., et al. (2021). Patient-Reported Outcomes in Malignant Ascites with Indwelling Peritoneal Catheters. Journal of Palliative Medicine, 24(1), 81-87. DOI: 10.1089/jpm.2020.0163
Dake, M. D., et al. (2018). Fusion Imaging in Interventional Oncology. Journal of Vascular and Interventional Radiology, 29(12), 1667-1678. DOI: 10.1016/j.jvir.2018.08.019
Piffaretti, G., et al. (2020). Artificial Intelligence and Machine Learning in Interventional Oncology. European Journal of Surgical Oncology, 46(7), 1339-1345. DOI: 10.1016/j.ejso.2020.03.003
Keshava, A. S., & Oklu, R. (2021). Robotic Systems in Interventional Radiology. Journal of the American College of Radiology, 18(2), 273-278. DOI: 10.1016/j.jacr.2020.09.027
Yang, X., et al. (2021). Emerging Combination Therapies of Interventional Radiology with Immunotherapy. Journal of Cancer Research and Clinical Oncology, 147(1), 187-197. DOI: 10.1007/s00432-020-03223-z
Scharll, Y., Radojicic, N., Laimer, G., Schullian, P., & Bale, R. (2024).
Puncture Accuracy of Robot-Assisted CT-Based Punctures in Interventional Radiology—An Ex Vivo Study, Diagnostics, 14(13), e1371, DOI: 10.3390/diagnostics14131371
Keisari, Y. (2023),Tumor ablation-induced anti-tumor immunity,Cancer Immunology, Immunotherapy, 72, Article e3383, DOI: 10.1007/s00262-023-03383-4
Referanslar
Schwartz, L. H., & Gandras, E. J. (2019). The Role of Percutaneous Biopsy in the Era of Advanced Imaging. Seminars in Interventional Radiology, 36(4), 304-311. DOI: 10.1055/s-0039-1698424
Wallace, M. J., et al. (2020). Image-guided biopsy of gynecologic malignancies: a systematic review and meta-analysis. International Journal of Gynecological Cancer, 30(6), 843-850. DOI: 10.1136/ijgc-2020-001221
Arellano, R. S., et al. (2018). Percutaneous Biopsy of Abdominopelvic Lesions: A Multicenter Study. Journal of Vascular and Interventional Radiology, 29(12), 1686-1692. DOI: 10.1016/j.jvir.2018.06.012
Patel, H., & Narsinh, K. (2019). Management of Malignant Ascites. Seminars in Interventional Radiology, 36(4), 312-317. DOI: 10.1055/s-0039-1698425
O'Neill, D. S., et al. (2017). PleurX Catheter Placement for Symptomatic Malignant Ascites. Journal of Palliative Medicine, 20(9), 986-990. DOI: 10.1089/jpm.2017.0093
Razavi, M., & Valente, P. (2015). Uterine Artery Embolization for the Treatment of Gynecologic Malignancy. CardioVascular and Interventional Radiology, 38(6), 1431-1439. DOI: 10.1007/s00270-015-1070-5
Cui, T., et al. (2020). Transarterial Chemoembolization (TACE) in the Treatment of Liver Metastases from Gynecologic Malignancies. Journal of Gynecologic Oncology, 31(3), e44. DOI: 10.3802/jgo.2020.31.e44
Hui, J., et al. (2021). Radioembolization with Yttrium-90 for Liver Metastases from Gynecologic Cancers: A Systematic Review. Journal of Vascular and Interventional Radiology, 32(9), 1450-1457. DOI: 10.1016/j.jvir.2021.05.006
Pishgahi, M., & Kim, M. S. (2019). Technical advances in microwave ablation. Journal of Cardiovascular and Interventional Radiology, 30(4), 517-526. DOI: 10.1007/s00270-019-02194-4
Gillams, A. (2017). Radiofrequency Ablation in the Treatment of Gynecologic Tumors. Journal of Clinical Oncology, 35(28), 3230-3236. DOI: 10.1200/jco.2017.74.8329
Russo, A., et al. (2019). Role of Interventional Radiology in the Management of Gynecologic Cancer. Current Oncology Reports, 21(4), 35. DOI: 10.1007/s11912-019-0775-6
Littrup, P. J., et al. (2018). Cryoablation for Pain Relief in Metastatic Cancer. Journal of Vascular and Interventional Radiology, 29(1), 108-115. DOI: 10.1016/j.jvir.2017.06.027
Ruzgys, J., & Dvorak, P. (2020). Irreversible Electroporation (IRE): A New Tool for Cancer Treatment. Medicina (Kaunas), 56(11), 606. DOI: 10.3390/medicina56110606
Liu, Y., et al. (2021). Percutaneous Nephrostomy and Ureteral Stenting in the Management of Malignant Ureteral Obstruction in Gynecologic Cancer. International Journal of Gynecological Cancer, 31(7), 990-997. DOI: 10.1136/ijgc-2020-002167
O'Connell, M., et al. (2017). Enteral Stents for Malignant Gastrointestinal Obstruction. Clinical and Experimental Gastroenterology, 10, 97-105. DOI: 10.2147/ceg.s101783
Berrisford, M., & Williams, J. (2018). Management of Chronic Pelvic Pain in Gynecological Cancer Patients: A Review. Pain and Therapy, 7(1), 1-10. DOI: 10.1007/s40122-018-0091-1
Flescher, L. T., et al. (2019). Management of Malignant Effusions with Indwelling Pleural Catheters. Annals of Palliative Medicine, 8(Suppl 1), S21-S26. DOI: 10.21037/apm.2018.12.01
Varghese, V., & Oklu, R. (2020). Artificial Intelligence and Machine Learning in Interventional Radiology. Seminars in Interventional Radiology, 37(4), 385-391. DOI: 10.1055/s-0040-1718873
Wang, Y., et al. (2018). Interventional Radiology in Gynecologic Oncology. Abdominal Radiology, 43(11), 2908-2921. DOI: 10.1007/s00261-018-1647-y
Al-Qahtani, A., & Lee, D. A. (2020). Image-Guided Ablation for Bone Metastases. Techniques in Vascular and Interventional Radiology, 23(3), 100713. DOI: 10.1016/j.tvir.2020.100713
Cornelissen, L. F., et al. (2019). Percutaneous Nephrostomy and Ureteral Stenting in Malignant Ureteral Obstruction: A Systematic Review. European Journal of Surgical Oncology, 45(6), 941-949. DOI: 10.1016/j.ejso.2019.01.002
Kim, J., et al. (2020). Interventional Radiology in the Palliative Care of Cancer Patients. Journal of Clinical Medicine, 9(12), 3907. DOI: 10.3390/jcm9123907
Munk, P. L., et al. (2020). Percutaneous Gastrostomy and Jejunostomy in Oncology. CardioVascular and Interventional Radiology, 43(1), 108-115. DOI: 10.1007/s00270-019-02384-6
Fiori, E., et al. (2018). Self-expandable metal stents for palliation of malignant gastric outlet obstruction. World Journal of Gastroenterology, 24(17), 1845-1854. DOI: 10.3748/wjg.v24.i17.1845
Loubser, M. D., & De Villiers, C. B. (2017). The Role of Interventional Pain Procedures in Palliative Care. Pain Practice, 17(7), 896-905. DOI: 10.1111/papr.12529
Tei, M., et al. (2019). Pelvic Cancer Pain: Interventional Management. Current Pain and Headache Reports, 23(10), 75. DOI: 10.1007/s11916-019-0824-0
Van De Bilt, C., et al. (2021). Patient-Reported Outcomes in Malignant Ascites with Indwelling Peritoneal Catheters. Journal of Palliative Medicine, 24(1), 81-87. DOI: 10.1089/jpm.2020.0163
Dake, M. D., et al. (2018). Fusion Imaging in Interventional Oncology. Journal of Vascular and Interventional Radiology, 29(12), 1667-1678. DOI: 10.1016/j.jvir.2018.08.019
Piffaretti, G., et al. (2020). Artificial Intelligence and Machine Learning in Interventional Oncology. European Journal of Surgical Oncology, 46(7), 1339-1345. DOI: 10.1016/j.ejso.2020.03.003
Keshava, A. S., & Oklu, R. (2021). Robotic Systems in Interventional Radiology. Journal of the American College of Radiology, 18(2), 273-278. DOI: 10.1016/j.jacr.2020.09.027
Yang, X., et al. (2021). Emerging Combination Therapies of Interventional Radiology with Immunotherapy. Journal of Cancer Research and Clinical Oncology, 147(1), 187-197. DOI: 10.1007/s00432-020-03223-z
Scharll, Y., Radojicic, N., Laimer, G., Schullian, P., & Bale, R. (2024).
Puncture Accuracy of Robot-Assisted CT-Based Punctures in Interventional Radiology—An Ex Vivo Study, Diagnostics, 14(13), e1371, DOI: 10.3390/diagnostics14131371
Keisari, Y. (2023),Tumor ablation-induced anti-tumor immunity,Cancer Immunology, Immunotherapy, 72, Article e3383, DOI: 10.1007/s00262-023-03383-4
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