Jeanne Laberge, San Francisco, USA, is an interventional radiologist of renown. She has been chosen to deliver SIR’s annual Charles T Dotter lecture on the topic “Data integration in interventional radiology—a pressing challenge for our time”. She said…
Moments that changed interventional radiology
In tribute to Charles Dotter, it is his groundbreaking insights and techniques that provided the critical transformation of diagnostic angiography into therapeutic vascular interventions. His description of a technique for percutaneous angioplasty in 1964 led the way for all that followed.
In my own field of hepatobiliary interventions, I would say that the experimental work of Julio Palmaz in the late 1980s with application of the first expandable stent to bridge the transhepatic channel in transjugular intrahepatic portosystemic shunt (TIPS) was a transformative moment. His subsequent work with Goetz Richter and others in the clinical application of this technique led to a major transformation in the care of patients with complications of portal hypertension. In this respect, I would also like to give credit to Josef Roesch who worked alongside Charles Dotter and deserves considerable credit for making the TIPS procedure what it is today. His technical and clinical work are key to the ultimate adoption of this procedure as a standard of care for the management of patients with refractory variceal bleeding and ascites. But Roesch’s most significant contribution may have been his tireless enthusiasm and support for young investigators in the field.
The most pressing research question in interventional radiology
I have two: What is the proper role for retrievable inferior vena cava filters? With the current US FDA focus on complications from retrievable filters, it is important for interventional radiologists to take the lead in performing outcomes research defining the benefits of this technology.
The other—is chronic cerebrospinal venous insufficiency a clinically important factor in the development and progression of multiple sclerosis? And, does balloon angioplasty and/or stent placement provide durable improvement of symptoms in multiple sclerosis patients?
This is a fascinating topic with considerable potential for patient benefit but we will only know the answers through careful clinical research. The interventional radiology community is divided in their prediction of the outcome of such studies. It will be very interesting to see what the answer is.
Growing the specialty
Innovation has always been the life-blood of the specialty and will continue to be. We must continue to inspire, encourage and foster young innovators who bring new ideas to the field.
But the special challenge of our specialty today is to prove the value of interventional radiology through data. We must show that image-guided interventions are safer, more effective and more cost-efficient than alternative therapies. This is the way to compete in the turf battles of the new millennium.
What does the SIR award mean to you?
It is a singular honour to be selected for this award. As my partner at the University of California, Dr Bob Kerlan said—now I can retire.