Geschwind J-F, Soulen MC, eds. Interventional Oncology: Principles and Practice of Image-Guided Cancer Therapy. 2nd ed. Cambridge Medicine; 2016; 346 pp; 94 ill; $199.00
Interventional oncology (IO) is a rapidly advancing and ever-changing field. So important has IO become in the treatment of patients with cancer that it is the fourth pillar of cancer care, with the traditional 3 being surgery, radiation, and chemotherapy.1 Diagnostic and interventional radiologists both play important roles in the clinical evaluation of patients and participate in multidisciplinary tumor boards. Participation in these boards is a must for the diagnostic and interventional radiologist alike. It is no longer sufficient for radiologist to merely show images and perform anatomic measurements of tumor response; rather, a thorough understanding of the disease process and multidisciplinary therapeutic options is required to add true value to the discussion.
Traditionally, IO has been thought of in the narrow scope of liver-directed therapy, such as that for hepatocellular carcinoma (HCC) or liver-predominant colorectal metastases. Now, IO encompasses bone ablation, prostate ablation, treatment of lung cancer, primary and adjunctive treatment of renal cell carcinoma, and a host of palliative care procedures.
This book showcases the breadth of pathology and the wide-ranging tools that interventional radiology and IO have at their disposal to treat patients with cancer. Specialists from around the world have contributed and authors are the definitive authorities on their topics (e.g., Riccardo Lencioni authors the chapter on the assessment and triage of hepatocellular carcinoma, and Peter Mueller and Debra Gervais author the chapter on the management of small renal masses).
Organized into a total of 10 sections, this book first discusses principles behind therapies (e.g., how Y-90 or radiofrequency ablation works) and then discusses specific modalities for the treatment of specific diseases (e.g., Y-90 for colorectal liver metastases and ablation for HCC). Reflecting the traditional role of IO in hepatic malignancies, 12 of the 31 chapters deal with primary or metastatic disease of the liver.
While most of the topics are not of primary concern to a diagnostic neuroradiologist, 2 chapters in particular would be useful to neuroradiologists. One on CT-guided neurolysis for cancer-related pain is a well-written and well-illustrated guide on when and how to perform celiac plexus, superior hypogastric, and ganglion impar neurolysis. Another chapter is dedicated to cementoplasty, discussing amongst other interventions vertebroplasty and kyphoplasty in metastatic spine lesions. One chapter which would be of significant interest to a diagnostic radiologist is a chapter on “novel developments in MR assessment of treatment response after locoregional therapy,” which discusses how the functional assessment of tumors (for instance, with volumetric contrast enhancement and diffusion-weighted imaging) is evolving and promising metrics.
Conspicuously missing from this book is a chapter on percutaneous biopsy. While many might rightfully think that biopsies are technically straightforward, there are evolving indications, and with this, one needs to know the amount and type of tissue needed. Understanding and meeting the oncologist’s needs as far as tissue sampling is concerned is the first step to gaining a seat at the table—a necessary prerequisite before one can perform the more advanced procedures such as Y-90 embolization. Perhaps the third edition will include this.
Another deficiency is on page 1, which is the first and only page of the section entitled “Principles of Oncology.” When I first looked through the index and saw this section, I anticipated a much-needed oncology primer so that I could try to learn the language of the medical and surgical oncologists, review basics of tumor biology, and review basic principles of chemotherapy and surgical oncology; however, this page serves not as a synopsis of the principles of oncology but rather as a preface for the book and the editor’s tips on IO practice building.
Compared to other recently published books, such as Practical Guides in Interventional Radiology: Interventional Oncology (editors Ripal T. Gandhi and Suvranu Ganguli by Thieme publishing), this book stands favorably. Chapters in this book are more detailed and the breadth is wider (this latter book lacks chapters dealing with image-guided neurolysis and palliative procedures).
Overall, I would recommend this book to any general diagnostic radiologist with a keen interest in oncology who regularly participates in tumor boards and is looking to become a more active participant at such conferences. A neuroradiologist looking to perform celiac plexus block or vertebroplasty might be better served with other books or existing review articles.2 The ideal readers for this book would be radiology residents, interventional radiology fellows, or fledgling attendings interested in IO.
- Hickey R, Vouche M, Sze DY, et al. Cancer concepts and principles: primer for the interventional oncologist—part I. J Vasc Interv Radiol 2013;24:1157–64, 10.1016/j.jvir.2013.04.024
- Kambadakone A, Thabet A, Gervais DA, et al. CT-guided celiac plexus neurolysis: a review of anatomy, indications, technique and tips for successful treatment. Radiographics 2011;31:1599–1621, 10.1148/rg.316115526