Interventional News speaks to Gao-Jun Teng, professor and chair of the Department of Radiology at Zhong-Da Hospital, Southeast University, Nanjing, China.
With around 3000 full-time and 2000 part-time interventional radiologists, China is a very important player in the interventional radiology world. Can you provide a brief outline on the situation of interventional radiology in China?
Interventional radiology was introduced to China during the 1980s in conjunction with China’s Open and Reform Policy. Although the practice of interventional radiology started relatively late in China compared with the Western world, it spread rapidly. The specialty was immediately accepted and welcomed by most radiologists after its introduction and the Chinese Society of Interventional Radiology (CSIR) was founded in 1990. Currently, there are around 5,000 full-time and part-time interventional radiologists in China and over a million procedures performed annually.China has benefited from the rapid development of economy; thousands of the state-of-art interventional radiology modalities such as digital angiography machine and open MRI are employed in more than a thousand of hospitals. However, we realise that there a lot of things we need to learn, including setting interventional radiology as a specialty, establishing a national criteria for interventional radiology and a national registry for interventional radiology procedures. In spite of that, interventional radiology seems promising in terms of the number of interventional radiologists in China.
What aspects of practicing interventional radiology in China are similar to the West and in what aspects is it unique in China?
In China, interventional radiology was introduced from the West, early from Europe, Japan, USA, and later from all over the world. Therefore, interventional radiology in China is quite similar to the West. However, it has grown in the specific soil of China and it has something special, in respect to the structure and management of interventional radiology. Over 50% of interventional radiology service (whether in the department of radiology or an independent department) has its own dedicated inpatient wards, and around one third of interventional radiologists are set up as an independent department (separated from diagnostic radiology). Interventional radiologists seem to be more proud of being full clinicians in China.
You have previously said that neurologists have become the most aggressive pursuers of interventional radiology practice in China… why and how?
In the past 10 years, neuro-interventional procedures for ischaemic carotid and intracranial arteries have dramatically increased in China. One of the reasons for such growth is because of great enthusiasm from neurologists, which may be different compared to the West for cardiologists. However, in my observation, such enthusiasm from neurologists has lessened recently. I believe another important reason for there being less competition for interventional radiologists may be due to insufficient training of clinical neurology and non-subspecialised neuroradiology in China.
What should interventional radiologists in China do in order to grow the field?
There are a lot of ways we should do in order to grow continuously in interventional radiologists in my country. In my opinion, the growth speed of interventional radiologists in China was good enough for the past 20 years. The major tasks for us are to ensure the quality of the interventional radiology services. We should have national criteria for the registry of interventional radiologists, national guidelines for interventional procedures, and a national registry network for interventional procedures. We need a national strong interventional society which is supposed to be a regular and more professional organisation like the Society of Interventional Radiology (SIR) or the Cardiovascular and Interventional Radiological Society of Europe (CIRSE). Also, we need to make interventional radiology more popular, “We should let every Chinese know about interventional radiology”, said former CSIR president Xiangsheng Xiao.
Who was the greatest Chinese interventional radiologist who influenced you and what did you learn from him?
The late Zi-Jiang Liu, who was professor and chair of the department of radiology and Guiyang Medical College and Zhejiang Provincial Hospital. Professor Liu was a pioneer of interventional radiology in China and served as CSIR president from 1994−1997. He trained the first generation of interventional radiologists in China in the 1980s. Although I was trained by him for only two months in the summer of 1987, I have been deeply influenced by his great enthusiasm and professional spirit for interventional radiology. He is still well respected by people today even though he passed away seven years ago.
How popular is the vision of an inpatient interventional radiology ward in China?
I have the data from 2007 when 51% of interventional radiology services had dedicated inpatient wards all over the country. The number should have increased to 10–20% today. Chinese interventional radiologists believe that the inpatient interventional radiology ward is very important to win the turf battle with other specialties. In some aspects the medical service in China is different from the West. For example, most patients at the medical centre come directly from outpatient wards in China, while these may be referred by primary practice physicians in the West. Therefore, the dedicated inpatient interventional radiology service has been developed and CSIR strongly supports such a structure of interventional radiology.
What is your key message to your colleagues in the West?
Interventional radiology in China is a relatively young specialty or subspecialty. It has become the largest one in the world in terms of the number of interventional radiologists. We are part of the interventional radiology family of the world and should contribute to it. CSIR and its members are happy to see more and more international connections between CSIR and other societies such as SIR and CIRSE. We are delighted to join in international affairs such as signing the “Global Statement Defining Interventional Radiology”. Personally, I have been happy to be one of the editors of CardioVascular and Interventional Radiology since 2009.