Many of our top 10 stories of March 2021 highlight new data and ideas presented at the annual scientific meeting of the Society of Interventional Radiology (SIR; 20–26 March, online), with our coverage of the Charles T Dotter and InspIRed Lectures, reporting on the two-year outcomes of Embosphere microspheres (Merit Medical) in genicular artery embolization (GAE), and write-up of the Medtronic-sponsored OPuS One clinical trial results garnering attention. Issue 81 of the newspaper was also published this month, featuring a cover story exploring the trend towards increased precision and quantification with ablative procedures in cancer treatments.
Ziv J Haskal (University of Charlottesville, Charlottesville, USA) delivered the 2021 Charles T Dotter Lecture at SIR 2021. He told his virtual audience that the “adrenaline-rush” of seeing or doing an elegant procedure that can alter the course of a patient’s life is often the career-inspiring doorway into interventional radiology. But cautions that, over time, there needs to be a pivot to a different approach—one in which drama and thrill-seeking play second fiddle to perfecting procedural medicine by standardisation and a focus on outcomes, so that satisfaction rests on providing planned, precise, evidence-based, immediate and longitudinal clinical care.
In the cover story for our latest issue, Interventional News spoke to various leading interventional radiologists working to make advance ablation. They argue that ablation is entering a new era of increased precision and quantification, with outcomes that match or surpass those of surgery. Whilst reaching equipoise with their surgical counterparts has been a goal for interventional radiologists since the advent of ablative treatments for cancer, some expert interventionalists claim that the increased precision of modern thermal ablation techniques, coupled with improvements in radiology, mean physicians are often treating smaller volume tumours. This now positions the procedure as the “definitive” treatment for select patients in some cancers.
3. GAE with Embosphere microspheres comparable long-term results to Imipenum Cilastatin particles in knee osteoarthritis treatment, study finds
Trisacryl gelatin microspheres 100–300μm in size can be considered for genicular artery embolization (GAE), a new study presented at SIR 2021 reports. Presenting the two-year outcomes of a study comparing Embosphere microspheres (Merit Medical), which are made of trisacryl gelatin, with Imipenum Cilastatin microspheres for GAE in patients with moderate to severe knee osteoarthritis, Shivank Bhatia (University of Miami Miller School of Medicine, Miami, USA) informed delegates that the particles are comparable in terms of pain reduction, and that there is a sustained effect up to two-years of follow-up.
In this Medtronic-sponsored educational supplement to issue 81 of Interventional news, the OsteoCool RF ablation system is under the spotlight. Elizabeth David (University of Toronot, Toronto, Canada) describes watching a “small Canadian invention” transform cancer care, and offers her insights from working at one of the first centres to use the device. Jason Levy (Northside Hospital, Atlanta, USA) gives the “compelling” OPuS One trial results, detailing how they confirm the role of percutaneous ablation in musculoskeletal metastases. He also authors a case report: Treating expansile L1 breast cancer metastases with the OsteoCool RF ablation system.
Fluidx Medical released details this month on the clinical use of their GPX embolic device, demonstrating its ability to block flow to small microvasculature and large tumour feeding vessels.
Our write-up of Haskal’s 2021 SIR Charles T Dotter Lecture (see 1 on this list for our video interview with Haskal). Speaking to the online audience, he claimed it is time for interventional radiologists to leave behind the “cowboy culture” that was the foundation of the discipline’s early, exploratory days, and to become “legionaries marching in service of data”.
7. Ablation-confirmation software must become the new normal for IRs to be competitive with surgeons
“If interventional radiologists wish to become competitive with surgeons, the availability of software enabling the accurate comparison of pre- and post-interventional CT [computed tomography] or MRI [magnetic resonance imaging] scans must become mandatory and routinely employed,” Luigi Solbiati argues in this opinion piece. He discusses the ablation-confirmation software he has developed with his team in Milan, Italy, and enthuses about the potential of artificial intelligence to refine and improve ablative outcomes in interventional radiology.
Genicular artery embolization (GAE) is “highly effective and durable” in reducing symptoms due to moderate-to-severe knee osteoarthritis that is refractory to other conservative therapy (such as joint injections and medication), and has an acceptably low toxicity profile. So concludes Siddharth Padia (University of California, Los Angeles, USA), in his SIR 2021 abstract presentation.
9. RFA with OsteoCool leads to “rapid and sustained” pain relief in patients with osseous metastases
Treating patients with metastatic bone disease by radiofrequency ablation (RFA) using the OsteoCool system (Medtronic) results in rapid and statistically significant improvement in pain scores, and provides sustained, long-term relief. SIR 2021 attendees were the first to hear the full cohort data from the Medtronic-sponsored OPuS One post-market clinical study in the “Abstract of the year” presentation, delivered by Levy to the virtual audience.
President of the American College of Radiology (ACR) Geraldine McGinty, also a radiologist and the chief strategy officer, as well as the chief contracting officer, at Weill Cornell Medicine (New York City, USA), presented the InspIRed Lecture at SIR 2021. She offered her reflections on “being a first”—in May 2018, McGinty was elected chair of the Board of Chancellors of ACR, the first woman to hold this office in the society’s nearly 100-year history.