• Image guided Tissue Sampling: it is often the first step in establishing definite diagnosis of cancer in the patient.

Sometimes on imaging alone, it is difficult to differentiate between cancer v/s non cancer conditions such as sometimes CT scan cannot differentiate between cavitatory neoplasm from infective cavitatory lesion as seen in tuberculosis or fungal disease and both may look identical. So it becomes necessary to took small sample from the lesion to document the presence or absence of the cancer.

Image guidance is mostly by USG guided and in few cases, CT guided

Tissue sampling is either by aspirating few cells from the lesion called as FNAC or by extracting small bit of tissue from the mass lesion called as BIOPSY

• IMAGING-GUIDED FLUID ASPIRATION: Sometimes starting of a cancer condition is only with pleural effusion or ascites fluid on presentation and imaging cannot assign the definite diagnosis of the condition. So, ultrasound or sonography guided aspiration of these fluid collections is done and fluid is then sent for laboratory examination for presence or absence of malignant cells Mostly, aspiration is done by small needle and syringe but sometimes patient may need drainage of fluid using a drainage catheter

These procedures do not have direct effect on tumor pathology and biology but definitely these procedures are adjuncts to the cancer disease and its treatment modalities like surgery, chemotherapy or radiotherapy.

• Central venous access
• PICC line or chemoport placement
• Enteral tube placement
• Image guided insertion of markers
• Nephrostomy and ureteric stenting
• Gastro-intestinal stenting – like esophageal or antral or colonic stenting
• Pre-operative embolization of vascular tumors
• Neo-adjuvant embolization
• IVC filter placement
• IVC and SVC stenting
• Biliary drainage (PTBD) with biliary stenting
• Tracheal stenting

A. Therapeutic procedures or Disease modifying procedures: These procedures has direct effect on tumor pathology and biology with direct intent to modify the disease progression and disease prognosis

• Ablation of the tumors: this can be used for tumors like osteoid osteoma of bone, solitary lung tumors, liver and kidney tumors and also lung, bone or liver metastatic nodule usually solitary. Ablation is done either using RFA(Radio-frequency) or microwave technique.
• Uterine artery embolization for the uterine fibroids
• Transarterial chemoembolisation – TACE: this is the treatment modalility of choice for non operable liver cancer called as hepatocellular carcinoma (HCC)

Post Surgery, chemotherapy or radiotherapy patient may suffer from minor to major complications which are effectively can be deal with INTERVENTIONAL RADIOLOGICAL procedures in the minimally invasive way. Some of the mentioned procedures include:

• Drainage of collections: with the use of ultr asound guidance, coactions in the abdomen or thorax can be drained using simple percutaneous draianage catheter without any major incision.
• Embolization : sometimes post surgey or radio-chemotherapy patient develops aneurysm or AV fistula or active bleeding from the operative site –using embolization materials like glue or PVA particles or coils these complications can be handled via the percutaneous transarterial route only
• PTBD + Balloon dilatation: used for post surgical malignant biliary strictures
• Pain management: such as celiac axis block
• Vertebroplasty

• Minimally invasive techniques
• Mostly OPD basis or Day care admission procedures
• Shorter hospital stay
• Greater comfort
• Reduced risk
• Lower cost
• General anesthesia usually not required, mostly under local anesthesia or nerve blocks
• Quicker Convalescence and quicker return to work
• Diagnostic , palliative and therapeutic spectrum
• No scar