As interventional radiology continues to grow and innovate, it’s critical that industry works with the specialty to develop the tools needed to support new techniques and treatments for patients. This partnership was on full display at the SIR 2017 Annual Scientific Meeting, in the Expo. We spoke to both IRs and industry leaders about trends in IR and the future of the specialty.
Many IRs are specializing in interventional oncology (IO), a trend that was reflected in the number of IO-related booths and demonstrations in the Expo Hall. IO provides IRs the opportunity to develop in-depth knowledge about a disease state, rather than focusing solely on a procedure, said Frank Facchini, MD, FSIR, SVP, head of medical affairs, BTG plc, and executive vice president of the private practice VIR Chicago. “Oncology is a place where you can really learn about those diseases that you concentrate on,” he said. “That is filling a remarkable need that intrinsically we have as interventional radiologists to contribute to the overall health care plan and outcome of the patient.”
Dr. Facchini points to immuno-oncology as an exciting opportunity for IRs to get in on the ground floor, to play a bigger role in the early stages of research. “We want to understand the early research, and there are very few areas in which interventional radiology has been afforded that opportunity.”
As the specialty steadily transforms from being one of procedure-based specialists to one of clinicians, IRs continue to evolve from being doctors’ doctors to their patients’ doctors—and their opportunities and responsibilities increase accordingly. Today’s IRs are providing longitudinal care for their patients, meeting their needs outside of the specific procedures they performed. “That’s an incredible opportunity,” Dr. Facchini said.
This increased involvement in the care of the patient—and the new reimbursement paradigm—is leading IRs to focus more on quality in outcomes. Pulmonary embolism (PE) is one example of that trend. “Pulmonary embolism is a natural place for the interventionalist to thoughtfully dive into because not all PE patients are the right ones to treat,” Dr. Facchini said. “We’re learning more about the disease to stratify the difference between submassive PEs. This allows us to dive deeper into the submassive PE population and realize that even in that there are the right and wrong patients to treat.”
Around the Expo
At SIR 2017, IRs took time to explore the SIR 2017 Expo Hall to keep up with the specialty’s trends. This was especially helpful for IRs not in academia, said Evan Harris, MD, an IR at the Center for Vein Restoration in Glastonbury and Cromwell, Conn. “There’s incredible innovation and new ways of thinking about old problems,” he said of the Expo. But, he said, the challenge is translating the ideas and techniques into procedures that are approved and reimbursed for in the United States.
As he explored the Expo, Robert Liddell, MD, an assistant professor in IR at Johns Hopkins Medicine, was interested in fusion software, the ability to combine two modalities for a procedure. For example, combining CT with an angiogram allows IRs to better plan out the procedure beforehand. “That is allowing us to more precisely deliver therapy to tumors, biopsy things, ablate areas,” he said.
Dr. Liddell noticed that the Expo provided displays on more in-depth technology, not just devices. “In general, it’s an exciting time to become more minimally invasive and less intrusive, allowing us to better do our jobs.”
Beyond the Expo, SIR 2017 programming reflected many other areas of growth in IR, including pediatric interventions, radioembolization, personalized medicine, genomics, immunotherapy and cellular-based therapies. There was also a session on imaging and intervention in lymphatics.
“Lymphatics have been traditionally difficult to fix, if broken,” said SIR 2017 Scientific Program Chair Daniel Sze, MD, PhD, FSIR. “At this point, interventional radiologists are leading this renaissance in how to deal with lymphatic disease.”
Overall, where the literature supports new IR technologies, patients should be allowed access to the best IRs have to offer, Dr. Harris said. “Implementation and acceptance of the brilliant innovations displayed at SIR will require IRs to be more than technical and clinical experts but also outspoken patient advocates.”
