01.03.2017 Saving brains and poisoning tumours: Interventional radiology in the ascendancy in Austria 

Prof. Hausegger Bild vergrößern

Cardiovascular disease and cancer are the most common causes of death in Austria. Interventional radiology focuses on both the diagnosis and treatment of these conditions. These new options also play a decisive role when it comes to treating high-risk surgical patients.

  • Time is brain: 10% of men and 6% of women over 60 suffer a stroke – acute therapy possible via catheter

  • Tumours are heated, bombarded, frozen and even poisoned:
    • Inoperable liver cancer tumours can be treated with transarterial chemoembolisation (TACE) – allowing for precisely targeted chemotherapy
    • Selective internal radiation therapy (SIRT) increasingly gaining a foothold in Austria – radiation therapy possible in the smallest of vessels

“There are 1,282 radiologists in Austria (status: Oct. 2016), 10 percent of whom specialise in interventional radiology, which means that they not only provide diagnoses, but are also involved in treating and permanently monitoring patients using medical imaging procedures.  In Austria, there is one interventional radiology centre in each province that offers this kind of expertise. In light of the trend towards functional, biological and genetic imaging, the significance of radiology in the diagnosis and treatment of disease is growing all the time,” explained Prof. Klaus A. Hausegger, Chairman of the Institute of Diagnostic and Interventional Radiology in Klagenfurt and President-Elect of the Austrian Roentgen Society. 

Improved treatment outcomes thanks to interventional radiology

With the support of x-rays, CT, MRT and sonography it is now possible to offer patients even more precise and efficient treatments, particularly when it comes to the vascular system and local cancer therapies: “the use of imaging makes it easier for us to set our sights on the ‘target’. In other words we can use probes to open vessels or pinpoint and treat tumours. And to shrink them we heat them up, bombard them with microwaves or freeze them. Innovative treatment forms such as transarterial chemoembolisation and selective internal radiation therapy mean that patients can be treated using locally administered chemotherapy and radioactive substances,” Prof. Hausegger noted. 

Treating liver tumours with cytotoxic drugs

Each year around 1,000 Austrians develop liver tumours, with males aged over 60 suffering from alcohol-related cirrhosis and people with hepatitis particularly at risk. With few noticeable symptoms in the early stages of this particular form of cancer, around 70% of cases can no longer be cured by the time the disease is detected, leaving palliative care as the only option. “Such tumours can reach up to 10 centimetres before being noticed. If it is not possible to surgically remove the liver carcinoma, then interventional radiology is used. We can get to the precise location of the tumour with catheters and attempt to destroy them by exposing them to extreme heat, or using transarterial chemoembolisation to inhibit growth,” Prof. Hausegger said. The latter involves injecting cytotoxic substances into the tumour site through a catheter in the liver artery. The vessel is subsequently blocked with an embolic agent to starve the tumour of its blood supply.  

SIRT – radioactive substances provide a new weapon

For a relatively short time now, selective internal radiation therapy (SIRT) has been used to treat malignant tumours that have already metastasised in the liver or have developed multiple smaller clusters. This combination of interventional radiology and nuclear medicine is already used at Vienna General Hospital to treat liver tumours and metastatic colorectal cancer, with the Klinikum Klagenfurt set to follow suit soon. In this treatment, minute particles are charged with a radioactive substance and injected directly into the blood vessels that supply the organ in question. The particles make their way into the small blood vessels that supply the tumour with arterial blood, become lodged there and irradiate the tissue locally. “From a logistics point of view, the technique is still extremely complex. Due to the low half-life of the yttrium used, which emits purely beta radiation, procedures of this nature must be timed exactly and require extensive preparation. While the method has huge potential, it is yet to become established,” added Prof. Hausegger, a leading authority on interventional radiology in Austria.  

Stroke: time is brain!

Cardiovascular disease is the leading cause of death in Austria. Stroke is life-threatening in 10 percent of men and 6 percent of women aged over 60. In acute stroke therapy, interventional radiologists take emergency measures immediately after diagnosis. The aim here is to remove the blood clots blocking major vessels in the brain as quickly as possible. With an ischemic stroke, blockage of one or several blood vessels in the brain results in the death of brain tissue. “This applies to 10-15% of stroke patients. ‘Time is brain’ is the watchword in stroke diagnosis, as for every half hour that passes without the thrombus being removed, the chance of saving the brain tissue drops by 9%,” Prof. Hausegger added. Miniature cannulas are used to remove the blood clot and re-establish the supply of oxygen, “helping us to improve the chance of recovery by at least 50%.” 

Interventional radiology at the ECR

According to Prof. Hausegger, the main advantage of interventional radiology is that it “helps to keep treatments as minimally invasive as possible. The chance of recovery is significantly increased without recourse to open surgery or chemotherapy. In many cases, no anaesthetic is required for procedures of this nature, and patients are only admitted to hospital for one or two days.” 

Radiology is not just about identifying lesions and drawing up differential diagnoses, it also involves a deeper understanding of how the human body works, how these lesions develop in the first place and how disease processes can be monitored and influenced using radiological techniques and image-based interventions. The ECR 2017 scientific program takes its inspiration from these groundbreaking processes and topics. 

ECR promoting the next generation of high flyers

The main focus of the 29th ECR is the new and ever-expanding Generation Y target audience. At 41.5 years, the average age of ECR participants is falling all the time, and women now account for almost 50 percent of the total. These developments are primarily down to the success of the European Society of Radiology’s (ESR) Invest in the Youth programme, which gives 1,000 trainee radiologists and radiological technicians who have submitted abstracts the chance to participate in the congress for free and covers their accommodation costs. The ECR also shows how best to respond to this demographic shift and meet the needs of all generations – from baby boomers to millennials – with a number of initiatives including interactive presentation media and various networking activities. 

About the ECR
The European Congress of Radiology (ECR) is the annual meeting of the European Society of Radiology (ESR), which represents more than 63,000 radiologists worldwide. Attracting more than 20,000 participants each year, the ECR is one of the largest medical conferences on the planet. It is also one of Europe’s largest industry exhibitions, with more than 300 international companies showcasing the latest advances in medical technology on more than 26,000m².

Press Release
Panorama Austria Center Vienna (c) IAKW-AG, pov.at
Hall ABC (c) IAKW-AG, Ludwig Schedl
Prim.Univ.-Prof.Dr.Klaus Hausegger (c) Klaus Hausegger

Internationales Amtssitz- und Konferenzzentrum Wien, Aktiengesellschaft (IAKW-AG) is responsible for maintaining the Vienna International Centre (VIC) and operating the Austria Center Vienna. The Austria Center Vienna is Austria’s largest conference centre, with 24 halls, 180 offices and meeting rooms, and some 22,000 square metres of exhibition space, and is one of the top players on the international conference circuit. IAKW-AG and the Austria Center Vienna are headed by Chief Executive Officer Susanne Baumann-Söllner.

IAKW-AG – Austria Center Vienna 
Elena Hajek 
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