“The Role of Interventional Oncology in Cancer Therapy: Ablative & Embolic Therapies“
Interventional Oncology (IO), the youngest and most rapidly growing offshoot of interventional radiology, has successfully established itself as an essential and independent pillar within the firmament of multidisciplinary oncologic care, alongside Medical, Surgical, and Radiation Oncology. What began as a limited, almost abstract idea of a minimally-invasive image-guided tumor therapy became a comprehensive and creative new specialty, driven by seemingly unlimited technological innovation. The perception of IO has evolved from suspicion, ignorance or skepticism into something that is fully accepted and demanded by knowledgeable oncologists, who seek our council as equals.
Tumor ablation is a minimally invasive technique that is commonly used in the treatment of tumors of the liver, kidney, bone, and lung. During tumor ablation, thermal energy is used to heat or cool tissue to cytotoxic levels (less than −40°C or more than 60°C). An additional technique is being developed that targets the permeability of the cell membrane and is ostensibly nonthermal. Within the classification of tumor ablation, there are several modalities used worldwide: radiofrequency, microwave, laser, high-intensity focused ultrasound, cryoablation, and irreversible electroporation. Each technique, although similar in purpose, has specific and optimal indications
Chemoembolization is the technique of injecting chemotherapy medication into the feeding arteries of a tumor along with particles designed to slow or stop the further arterial supply of oxygen and nutrients to that tumor. It has been performed since the late 1970s., It is one of several techniques used with the goal of treating either primary liver cancer or cancer metastatic to the liver. The most common primary liver cancer is hepatocellular carcinoma (HCC). Common types of metastases to the liver include those from the colon, breast, carcinoid, soft tissue sarcomas, and melanoma. Arterial chemoembolization also can be termed transarterial chemoembolization (TACE).
Radioembolization is a catheter-based liver-directed therapy that involves injection of micron-sized embolic particles loaded with a radioisotope by use of percutaneous transarterial techniques. Cancer cells are preferentially supplied by arterial blood and normal hepatocytes by portal venous blood; radioembolization therefore specifically targets tumor cells with a high dose of lethal radiation and spares healthy hepatocytes. The antitumor effect mostly comes from radiation rather than embolization. The most commonly used radioisotope is Yttrium-90. The commercially available devices are TheraSphere® (glass-based) and SIR-Sphere® (resin-based).
Dr. Abbas A. Chamsuddin, MD, FSIR, FPAIRS
A. Current Titles and Affiliations:
Current Position: Clinical Professor, Department of Radiology, Balamand University, Beirut, Lebanon 7/1/2009-Present Residency Program Director
B. Previous Academic and Professional Appointments:
- Assistant Professor of Radiology, Emory University School of Medicine, January 1, 2004 – February 28, 2007
- Associate Professor of Radiology, Emory University School of Medicine, March 1st, 2007-June 30th 2009
Clinical appointments: Vascular and Interventional Radiology-Emory University, Division Director, January 1, 2004 – June 30th, 2009
C. Other administrative appointments:
- Vascular and Interventional Radiology, Fellowship Program, Director, January 1st, 2004-June 30th, 2009
- Emory Staff Faculty Radiologist: Vascular and Interventional Radiology, January 1st, 2004-June 30th, 2009
- Assistant Professor, Department of Radiology, University of Tennessee, Memphis, Memphis, TN, July 1st, 1999-December 2003
- Director, Vascular/Interventional Radiology, Fellowship Program Director, University of Tennessee, Memphis, July 1, 2000-December 2003
- Specialty Boards: American Board of Radiology-Diagnostic Radiology: Initial Certification: June 1998, Maintenance of Certification (MOC): April 2012
- American Board of Radiology: CAQ in Interventional Radiology: November 2000, Maintenance of Certification (MOC): April 2012
- American Board of Radiology: CAQ in Nuclear Radiology: November, 2000 Maintenance of Certification (MOC): April 2012 American Board of Laser Surgery, October 2014
D. Leadership roles:
Pan Arab Interventional Radiology Society: