Advances in interventional radiology

To patient Kim Hornung, interventional radiologists and their team are among the “unsung heroes” of Newton-Wellesley.

In February of 2020, a dangerous blood clot led her to the NWH Emergency Department. She vividly remembers how Shams Iqbal, MD, reassuringly shook her hand when they met late that night. She feels indebted to him for immediately resolving the issue. “For me, it was life-saving,” she says.

Like many people, she’d never heard of interventional radiology. In sharing her story, “I want others to know that IR is a hidden gem,” she reflects. She describes everyone on the entire IR team at NWH as consummate professionals—from the doctors and nurses to the surgical team to the administrative staff. “I couldn’t be more grateful for their stellar care,” she says.

Fewer risks, quicker recovery

Newton-Wellesley began building a dedicated IR team five years ago, working in partnership with Mass General. The move reflects the broader goal of offering high-end services in the community, explains Anand Prabhakar, MD, chair of the Department of Radiology.

Interventional radiologists are specialists trained in minimally invasive, image-guided therapies. “IR is one of the most advanced and innovative specialties in radiology,” he adds.

Real-time imaging techniques allow these specialists to see inside the body and precisely treat a wide array of conditions. By often requiring the smallest of incisions, IR procedures allow patients to face fewer risks of complication and recover more quickly than after traditional surgery.

In the past, acute cases had to be referred to MGH. Now, patients can get even the most complex care locally, says Sanjeeva Kalva, MD, chief of Interventional Radiology for Mass General Brigham and a guiding hand in developing the NWH program. Patients are getting older and living longer, he adds. At more advanced ages, some may no longer be fit for surgery. In many cases, IR offers treatment that can be done more quickly and with less trauma.

Since its introduction, demand has grown 30 percent year over year. Looking ahead, Dr. Prabhakar sees IR as naturally aligned with a growing focus on access to care. Already, “we’re helping patients to get the care they need and get home faster,” he says.

Passion for patients and the field

Dr. Iqbal was the team’s first hire in 2019, brought on board because of the breadth of his experience and expertise. To Kim, his passion for both his patients and his field shows through in every interaction.

As he says emphatically, “We love what we do!” In a field known for innovation, the challenge excites him. “We are the ones who think outside the box,” he reflects. He appreciates bringing different resources and approaches to tackling medical conditions.

He breaks from his reflection to jump into a liver biopsy procedure. The team already has their patient prepped as he enters the small treatment room within the Radiology space. He makes a 2 mm incision—“you won’t be able find tomorrow”—through which he deftly uses a tiny needle to take a biopsy. He uses ultrasound to guide him, frequently pausing to be sure of the patient’s comfort. A pathologist is on hand to collaborate, making sure they get what they’ll need for an accurate diagnosis.

Forty years ago, the patient would have undergone two hours of open surgery, Dr. Iqbal notes. Today, it takes less than half an hour and is much less invasive.

Treating every part of the body

While interventional radiology is just beginning to gain visibility, “it’s at the center of medicine,” reflects his IR colleague, Sishir Rao, MD. “We’re able to treat every part of the body from head to toe.”

Today at Newton-Wellesley, patients with cancer are a major beneficiary. Along with being called on for biopsies and placing ports for infusion, IR also offers a means in a significant number of cases to treat tumors at their source.

The specialty traces its roots back to the early 1960s and the development of angioplasty and catheter-delivered stents. Blood vessel disorders—and clotting disorders as Kim experienced—are an ongoing focus.

The team also offers treatment for uterine fibroids, often on an outpatient basis, as well as for prostate issues. Other procedures help with musculoskeletal issues, relieving pain in the knees, back, and shoulders.

“You pick an area of the body, and IR is helping,” Dr. Rao concludes. Like his colleagues, he’s excited by even greater possibilities on the horizon.

“It’s one of the most technology-driven fields in medicine,” he adds. “We’re using tech to provide innovative care that lets people get home and on with their lives.”

“The best of the best”

Interventional radiologists continually collaborate with other specialties—from oncology to neurosurgery to cardiology. “It’s a discipline that touches every single discipline,” Dr. Prabhakar reflects. A team approach is critical. “We all work together to better our patients’ lives,” adds Dr. Kalva, echoing the point.

Being part of the wider MGB system enhances collaboration as well among interventional radiologists themselves. “We have great relationships,” says Dr. Rao. Ultimately, “what’s really wonderful about it is being able to bring high-end care out into the community.”

For patients, “living in the Boston area, we’re privileged to have the best of the best when it comes to medical care,” Kim believes. She’s thankful to NWH—”my lifelong hospital”—for adding IR as a new dimension of life-improving and life-saving care.

And she’s simply grateful to be alive.