Introduction

Article Outline

• Copyright

The role of interventional radiologists in the management of patients with cancer has grown tremendously in the last decade and is likely to grow even more in the near future. Because of the continuous transformation of their specialty, it has become important for interventional radiologists to become familiar with basic concepts in oncology. This is especially true given the impact image-guided locoregional therapies have on patient care, not only for palliation but also increasingly for cure.

Why devote an entire issue of Techniques in Vascular and Interventional Radiology to the clinical management of oncology patients? There are several answers to this question. First, the acceptance of interventional oncology as a legitimate subspecialty in oncology along with radiation, surgical and medical oncology is growing. Second, it is critical for interventional radiologists to speak the same language as their clinical colleagues in oncology. Third, interventional radiologists must be able to handle basic clinical management issues especially if they are to admit cancer patients to their services. Fourth, the growing reliance of interventional radiologists on physician extenders such as physician assistants and nurse practitioners must be clearly defined. Finally, the impact and importance of interventional oncology from the financial standpoint on radiology departments’ bottom lines must be well understood. Although it is true that the strength of interventional radiologists lies in the technical ability to perform image-guided procedures, it is imperative to evolve into complete clinicians. To that end, interventional radiologists interested in oncology must attend the hospital tumor boards, attempt to publish in dedicated oncology journals and present their research at oncology meetings. A recent editorial in the Journal of Hepatology (2007;46, 362-364) stressed the growing role of interventional radiology in the treatment of patients with hepatocellular carcinoma. Yet, the authors lamented the fact that interventional radiologists have not been able to establish definitively their therapeutic approaches because of an inherent inability to enroll patients in trials, and a focus on techniques rather than true clinical outcomes. To combat this image of “technician” that continues to plague interventional radiologists and negatively impact the acceptance of interventional radiology into the world of clinical medicine, the emphasis in terms of training and everyday practice must shift away from a procedure-oriented to a disease-based clinical approach. This issue of Techniques in Vascular and Interventional Radiology should provide a rationale for this change in approach and allow the readers to acquire basic knowledge that will serve them well in establishing themselves as true clinical interventional oncologists.

I and Drs. Georgiades and Hong, my coeditors, would like to thank all the authors for their remarkable contributions to this special issue of Techniques in Vascular and Interventional Radiology.