The field of science and medicine has come a long way since the old days during which a surgeon would amputate a soldier’s leg with a rusty old saw. As technology in healthcare continues to evolve to become more innovative, the importance of holistic care has also become increasingly recognised.

Integration of both factors mean that surgeons now use more cutting-edge technology during surgical procedures – such as laparoscopic surgeries – to ensure that patients have minimal risk, faster recovery time and improved health outcomes.

As health experts continue their efforts to define the future of medicine through innovative care, more breakthroughs in technology and imaging techniques have paved ways for newer and effective treatment alternatives that eliminate the need for open surgeries.

Unique combination of skills required

Interventional radiologists are radiology specialists whose expertises involve diagnosing and treating diseases using minimally-invasive image-guided procedures, such as X-ray, ultrasound (US), computed tomography (CT) as well as magnetic resonance imaging (MRI).

Interventional radiology is one of the biggest advances in medical practice which covers nearly every organ system, and the extensive range of diagnostic and therapeutic procedures includes, but is not limited to, stenting, arterio-venous fistuloplaty, arteriogram, central venous line insertion and tumour ablation – a specialty that requires a unique combination of skills.

"There is a difference between a diagnostic radiologist and an interventional radiologist,” explained Dr Tai Ket Sang, a resident interventional radiologist in Sabah. “While the former does X-rays and reads the images, as well as carries out CT Scan and does reports, the interventional radiologist will do that also but goes a step further to do treatment procedures.”

The theory behind this field is to make use of the least invasive techniques over traditional surgical procedures to diagnose or treat patients, in order to reduce risks and minimise pain, potential complications as well as recovery times – all in all to improve overall health outcomes.

“In Interventional Radiology, we can get to any part of the body. The procedure is performed using a needle to make a small hole to get to the artery in the arm or groin, and a wire to guide the catheter to the targeted area, instead of making a large incision into the body,” Tai described.

"It takes time to convince people that many conditions which used to be treated surgically can now be treated by the interventional radiologist. The range is quite big," he added.

Interventional radiology: A specialty of its own?

The field of interventional radiology is still young in Malaysia, having first originated in 1968 with the advent of diagnostic angiography in University Malaya Medical Centre, known as University Hospital back then. Meanwhile, the highly specialised field has seen a tremendous growth in Singapore since the first X-ray services were established in the country in 1898, and there are interventional radiology services currently provided in every public hospital in the country.

Interventional radiology offers doctors plenty of stimulating challenges and allows opportunities to use sophisticated state-of-the-art medical equipment. It is also a well-paid specialty – according to the Australian Taxation Office, interventional radiologists can earn up to $386,003 per annum.

Though the specialty is fairly new, the demand for newer treatment modalities utilising interventional radiology is steadily increasing, particularly as patients will invariably opt for minimally invasive techniques over more invasive surgical procedures.

Yet, the field may face difficulties in growth despite the increase in demand, as doctors from other clinical specialties branch out to learn minimally-invasive image-guided techniques that are desired in their own specialty. Cardiologists and vascular surgeons for example, are becoming increasingly involved in performing procedures such as peripheral vascular and aortic stenting.

If fewer doctors choose to specialise in interventional radiology as a specialty of its own, the future of interventional radiology as an independent field may not be promising, and the expertise of performing image-guided procedures may soon become an essential skill acquired by doctors across all specialties. MIMS

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