Interventional Radiology Achieves Specialty Status

The following article was written by Jeanne M. Laberge, M.D., a Professor in Residence in the Department of Radiology and Biomedical Imaging at UCSF.

Recognizing the growing importance and value of Interventional Radiology (IR) to medicine in general – and to patients specifically – the American Board of Medical Specialties (ABMS), the professional organization that decides which groups should be recognized as specialties within medicine, has approved the application from the American Board of Radiology for a new Dual Primary Certificate in Interventional Radiology and Diagnostic Radiology.

The approval by the ABMS also underscores the importance of interventional radiologists as clinicians. Now interventional radiologists see patients in clinics, provide clinical consultations to other doctors and actually manage patient care with respect to the therapies that they provide.

IR initially developed out of diagnostic radiology in the early 1980s, when advanced imaging technologies like CT and ultrasound were just starting to be used to direct non-operative therapies such as abscess drainage. That approach has grown to become a much more significant part of medicine today.

IR practitioners derive their skill and proficiency from their expertise in diagnostic radiology. They are very well-versed in such sophisticated imaging technology as CT, ultrasound and MR, and they therefore can use those imaging tools and techniques to guide therapy performed through needles and catheters without the need for open surgery.

The American Board of Radiology, one division of the ABMS, applied for this dual primary certificate because the interventional radiologist has become much more of a clinician who actually takes care of patients. To illustrate how interventional radiology has evolved, interventional radiologists now provide a variety of different treatments – that are not operations – to manage patients with advanced cancer therapy. For example, patients with a primary liver tumor called a hepatocellular carcinoma have a wide variety of treatment options, including several that are provided by interventional radiologists.  One treatment involves injecting chemotherapy or embolic agents through the arteries that supply the tumor in the liver. This is an example of a therapy that is very sophisticated, and whether to do it and how to do it really depends on the expertise of the interventional radiologist. As a result, the standard of care is for the interventional radiologist to participate in patient management decisions alongside the medical oncologist, the radiation therapy oncologist and the surgical oncologist to help patients and their families decide which are the best procedures to perform. This allows patients to get all the information they need to make critical decisions affecting their life expectancy. After the procedure the interventional radiologist will see the patient to make sure that he or she is followed up appropriately and to handle any problems that may arise.

I should add that in the U.S. there are two parallel professional organizations for training and certifying doctors. The ABMS certifies competency of doctors, whereas the Accreditation Council for Graduate Medical Education (ACGME) oversees training programs. While the ABMS has decided that interventional radiologists should be competent in clinical care in IR, now the matter is before the ACGME, which must determine how to implement training programs to ensure that these specialists are well trained in IR.

news release from the Society of Interventional Radiology provides more detailed information.