Biopsy, needle localization, and radiofrequency ablation for pediatric patients

IR challenges in the MSK system

As the capability of medical imaging equipment improves, and relatively new modalities such as cone beam CT with guidance becomes more widely available, the range and complexity of image guided orthopedic procedures continues to expand. Challenges include the predictable technical and anatomic issues, as well as the complex operational and political issues associated with moving and integrating an interventional radiology service into the traditional operating room environment.

Controlling radiation exposure during interventional procedures in childhood cancer patients

Many pediatric cancer patients undergo multiple diagnostic and therapeutic radiologic procedures over the course of their illnesses and are therefore at high risk for radiation exposure. There are a variety of measures that radiologists can employ to reduce this risk. These include limiting the use of radiation whenever possible, using specific strategies to reduce radiation exposure during interventional procedures, using quality assurance programs to ensure compliance, and maintaining continuing staff radiation safety educational programs. Some of the diagnostic and therapeutic interventional radiologic procedures that are performed in pediatric oncology patients are discussed here, along with specific tips for managing radiation exposure.

Interventional radiology and the care of the pediatric oncology patient

Interventional radiology has become increasingly involved in the diagnosis and management of the pediatric oncology patient. Percutaneous biopsy and needle aspiration can be performed for solid and liquid lesions with image guidance, both for the primary diagnosis and for management of sequelae of cancer therapy. Therapeutic options also can be performed with image guidance, including radiofrequency ablation and transarterial chemoembolization. When surgical resection is required, image guided tumor localization can be used to aid in identifying small lesions.