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Editor’s Page

The 2005 RadioGraphics Monograph Issue: Vascular and Interventional Radiology¹

¹ From the Department of Radiology, Division of Vascular and Interventional Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8834. Received and accepted August 16, 2005. Address correspondence to the author (e-mail: dmcoldwellmd{at}aol.com).

Editor’s Note.—This year’s October special issue is the seventh in the series of annual monographs on a subspecialty topic in imaging. The monograph series in RadioGraphics is extremely important to the mission of the Journal: quality education for radiologists in all subspecialties of radiology. Guest editor Dr Doug Coldwell and his authors, panelists, and reviewers have done a superior job in giving us an overview of interventional radiology, including the state of the art and future directions. These two important aspects of education in radiology remain the major focus of the yearly monograph issue.

Interventional radiology is a rapidly evolving subspecialty that is extremely important to our patients, referring physicians, and our specialty. I am indebted to Doug Coldwell for his vision, leadership, and hard work on this great issue of RadioGraphics. I know that Journal readers will enjoy the excellence of this monograph and will gain a valuable perspective on this important subspecialty.—WILLIAM W. OLMSTED, MD

Since my first exposure to it in 1981, interventional radiology has been transformed from "Specials"—a term that insinuates these techniques were only procedures and not a distinct subspecialty—to a vibrant, independent specialty that continually transforms itself. We have seen the comings of new procedures such as TIPS (trans-jugular intrahepatic portosystemic shunt), the expansion of old ones such as chemoembolization with new materials, and a complete change in our case mix due to other specialties’ acquisition of our former routine cases. Interventional radiology has reoriented to other, less controversial, and, at least for now, less competitive arenas in which we are currently leading. However, we must continually be aware of the marketplace and our advantage in innovation as it is how we all got here. There is a tinkerer inside every interventional radiologist.

With the able assistance of RadioGraphics vascular and interventional radiology panelists and reviewers, we have selected a number of articles for this issue that reflect the state of the art in interventional radiology as it is currently practiced worldwide. The authors are from nearly every continent and truly represent a cross-section of the interventional radiology world. The articles are divided into three major groups: oncology, uterine fibroid therapy, and more traditional applications of interventional radiology. The emphasis on oncologic therapies demonstrates that one of the new directions in interventional radiology is aggressive local-regional therapies for both primary and metastatic tumors. The oncologic topics discussed range from an exploration of tumor blood supplies, which are not immediately obvious from the arteriogram but may be after the computed tomographic (CT) images are reviewed, to an evaluation of new embolization technologies for therapy or diagnosis with molecular imaging techniques paired with magnetic resonance angiography. Percutaneous nonvascular interventional therapies such as radiofrequency ablation and its newest cousin, microwave ablation, are reviewed for their effectiveness and complications.

Uterine fibroid embolization is a distinct area of interventional radiology, and two articles examine the effectiveness of these techniques as well as the imaging findings of complications. These articles should be mandatory reading for anyone involved in the treatment of these patients.

Finally, more traditional interventional radiology applications are also addressed, with articles on newer aspects such as stent-grafts and treatment of iliac artery aneurysms. CT angiography in the trauma setting is explored. From personal experience, this technique is one of the most useful means of detecting extremity vascular trauma and has saved countless hours of interventionalist’s sleep. Interventions in the spleen and for peripheral vascular malformations are described; these techniques provide accurate, less morbid methods of treating two difficult areas. Finally, a bane of interventional radiology, adrenal venous sampling, is reviewed and actually made straightforward.

These articles represent the cutting edge of interventional radiology. Many of the techniques discussed were not even considered 10 years ago. My question for the interventional radiology community and the radiology community at large is this: What will be available in 10 years that we are not thinking of now?

I wish to express my appreciation to Bill Olmsted, who has held my hand the past year guiding me through the maze of editorial business, and my admiration of the staff he has put together: They are the A-Team. Finally, I wish to thank my colleagues and family for their patience and support.

This Article Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Coldwell, D. M. Search for Related Content PubMed Articles by Coldwell, D. M.