Week 3: IR

This week, for first time in my life, I observed a procedure done on a human. The first day I felt I wouldn’t be able to handle seeing human blood. But the second time I managed and, from then onwards, it has been so much fun seeing how radiology is used to aid in minimally invasive surgery. I just fell in love with IR J.

I was able to shadow a doctor performing embolization on a liver tumor. This was a colon cancer metastasis into the liver. Since the tumor draws blood from the artery in contrast to the non-tumor tissue, it is effective to block the blood supply to the tumor by embolization, which will only affect the tumor.

The doctor first used ultrasound (US) to locate the blood vessel, then after injecting the tube/wire, he utilized fluoroscopy to guide the wire to the area where the tumor was located. Then live fluoroscopy was utilized to locate the correct vessel to occlude, meaning the vessel that was feeding the tumor with blood. Correct sized beads were then injected to occlude the blood vessel.

I shadowed another doctor performing tumor ablation in the lung, using cryo method. In this case argon gas is used, where probes are injected into the tumor by aid of CT. In contrast to fluoroscopy, CT doesn’t provide live view, instead the doctor will locate probe injection location by CT, go do the injection and come back take CT images to see if the injection was right. The process goes back and forth till the probes are in the right location. The probes are then run in cycles of freezing and thawing. Freezing ruptures the cancer cells and destroys the organelles.

Even though fluoroscopy provides live view, it only offers 2D view compared to CT, which provides a 3D view.

I have also shadowed other IR procedures such as port placement for catheters, Urethra fibrosis Embolization, etc. But the two procedures involving tumor treatment were the most interesting to me.