Hepatobiliary cancers, including liver and bile duct malignancies, present significant global health challenges. Imaging modalities such as MRI and CT are pivotal for diagnosis, while percutaneous transhepatic cholangiography (PTC) aids in both diagnosis and treatment guidance under fluoroscopic control. Interventional radiology (IR) plays a crucial role in hepatobiliary cancers across diagnostic, palliative, and therapeutic domains.
Diagnostic Interventional Radiology: In IR diagnostics, imaging modalities like CT, MRI, and ultrasound are employed to characterize liver lesions and guide biopsies. Fine needle biopsy, utilizing a 21-25 gauge needle, offers rapid, cost-effective sampling with low complication rates. Core biopsy, using a 16-18 gauge tru-cut system, provides more detailed pathological information despite slightly higher risks. Percutaneous transhepatic cholangiography (PTC) assists in visualizing bile duct involvement and obtaining biopsies when endoscopic access is inadequate.
Palliative Interventional Radiology: For palliation in obstructive jaundice from biliary obstructions (often due to malignancies), procedures aim to restore bile flow using endoscopic or percutaneous drainage. Biliary stenting may follow drainage, with self-expanding metallic stents preferred for durability and efficacy. These interventions improve quality of life by alleviating symptoms and preparing patients for further treatment.
Therapeutic Interventional Radiology: Thermal ablation techniques like radiofrequency (RFA), microwave (MWA), and cryoablation (CrA) offer curative options for liver tumors ≤5 cm, sparing healthy tissue and minimizing complications. Transarterial chemoembolization (TACE) and transarterial radioembolization (TARE) target tumors via hepatic artery access, delivering chemotherapy or radiation internally to enhance efficacy and reduce systemic side effects.
Conclusion: Interventional radiology serves as an essential adjunct to traditional oncological approaches in hepatobiliary cancers, offering diagnostic clarity, palliative relief, and curative treatment options. Advancements in IR techniques continue to expand therapeutic possibilities, improving outcomes and quality of life for patients worldwide.