What is the purpose of interventional radiology

The expert forum in August: Interventional Radiology
Future of Interventional Radiology

We are planning maintenance work on April 12, 2010 from 11 a.m. to 6 p.m.
Dear PD Dr. Landwehr,

I am currently considering starting a specialist training in radiology. I find interventional radiology in particular very exciting, because here you stand close to the patient, are also active in therapy and manual skills are also an advantage.
However, I ask myself what interventional radiology will look like in the future, how are interventional radiologists positioned in competition with other specialist disciplines? E.g. vascular surgeons and angiologists increasingly want to perform PTA ect, just like kypho- and vertebroplasties are also performed by orthopedists.
How do you think it will be in 20 years? Are the methods adopted from the classic subjects of patient care?
I would also be interested in whether, as a specialist, you have the opportunity to work independently in the interventional area, possibly in cooperation with a clinic. Are there any promising models for this? Which range of services are particularly suitable for this.

I would be very grateful for answers.
  • Hello,

    I can only agree with my predecessor's questions.
    How likely is it that radiology can prevail over cardiologists, for example.
    Already today it is regulated differently in every house who does what.
    Nevertheless, you have to ask yourself whether at some point the radiologists will no longer intervene at all, since every department wants to take action itself.
    How do you assess the situation?

    Thanks for the answers.

    Anne Schmitz on August 6, 2010 at 12:34 p.m.
  • Dear Ms. Schmitz, dear Mr. Strobl,
    I can understand your thoughts and questions very well. Interventional radiology is an extremely exciting and future-oriented area of ​​medicine. In many areas, not just in radiology, minimally invasive methods are becoming increasingly important. There are many reasons for this: less invasiveness with equally good or better results, lower costs, shorter hospital stays and options for outpatient interventions are just a few examples.

    As with all expansive developments, however, this is also a “danger” for radiology as a whole, as it also changes the scope of many other subjects. Think about vascular surgery: Today, for example, more than 30% of operations in abdominal aortic aneurysms are carried out endovascularly; PTA or stents have replaced many open surgical vascular procedures. It is understandable that vascular surgeons who see their specialty at risk want to acquire expertise in originally interventional radiological procedures and do so. This development is also taking place in non-invasive areas: radiologists perform clinically meaningful cardiac imaging, cardiologists seek cardio-MRI as a response; Radiologists have made many diagnostic arthroscopies unnecessary with MRI, and orthopedic surgeons are therefore striving for musculoskeletal MRI; With MR angiography, radiologists provide excellent vascular diagnostics, angiologists now also want to perform MR angiographies, etc. There is a lot of “professional policy” taking place here, which you should register critically, but also consider with the necessary distance. Imaging and interventions require a lot of medical and technical expertise, but also high investment costs, so that I am firmly convinced that in many facilities, perhaps apart from some large clinics, these procedures from radiology will not be so easy (because they are also uneconomical) just break out.

    If we look at the period of 20 years you mentioned and ask ourselves, 'What was radiology like back then, how is it today, how will it be tomorrow?' And look back at the past, we see the following: Like any other discipline there has also been change in radiology. Many procedures have been added or have developed almost explosively like MRI or interventions, some procedures have also developed from radiology into other areas. This is actually a normal process and makes it appealing, because progress is always exciting. Of course, 20 years from now, interventional radiology will be different than it is today. It will also have to orientate itself towards changes in the healthcare system. This is already visible today: We increasingly have interdisciplinary centers such as vascular centers, breast centers, visceral centers or oncological centers. Here specialists from many disciplines work together, because there cannot and will not be one mega-specialist (e.g. for vascular diseases) who then masters all the procedures. Holistic, disease-oriented work without classic specialist or departmental boundaries is definitely the future. This dictates requirements for quality and economy.

    So today, when you are thinking about which specialist training you should aim for, you shouldn't philosophize so much about what a current discipline will look like in 20 years' time. Nobody can predict this for you either. Rather, I recommend that you decide on a subject (and a training center) in which you can learn the tools and procedures that can make your work fun and that suit your inclinations, today and in the years to come. One thing is certain: Interventional radiology procedures certainly have a great future. If you build up expertise here and do not neglect the clinical context, you have excellent career prospects. It is also clear that you have the best opportunities to achieve this goal in radiology today: the range of interventions is by far the largest there, you have all the imaging procedures required for this (which you must also master for the interventions ) 'Under one roof', and interdisciplinary thinking is taught to a radiologist from scratch. Perhaps in 10 years you will find yourself working as an interventional oncology radiologist in the team at an oncology center or as a vascularly oriented interventionalist in the team at a vascular center. Even as a resident radiologist with an interventional focus, you can work broadly interventionally with suitable cooperation or connection to a hospital. There are certainly examples of this from practices that offer a broad spectrum from PTA and stent to biopsy and chemoembolization.

    If you have not already done so, I would like to sit in on you for some time in a broad-based diagnostic and interventional radiology department. I am happy to assist you with the mediation so that you can get a contact person close to your home.

    With best regards
    Peter Landwehr

    Peter Landwehr on August 7, 2010 at 1:02 pm