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Diagnostics
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Interventional Radiology in 2025–2026: From Technological Innovation to Clinical Optimization
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Interventional Radiology in 2025–2026: From Technological Innovation to Clinical Optimization

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (30 April 2026) | Viewed by 6772

Editor

Dr. Francesco Giurazza

E-Mail Website
Guest Editor
Department of Vascular and Interventional Radiology, Cardarelli Hospital, 80131 Naples, Italy
Interests: application of interventional radiology in the fields of emergency; vascular diseases and oncology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Interventional Radiology (IR) boundaries are expanding year by year with new fields of application and technical developments. Nowadays, many emergency, oncology, and vascular diseases are handled with mini-invasive approaches, both in peripheral and neurological environments; this is related to high clinical values of the procedures associated with low complications and hospital stay, ending in favourable cost-effective ratios.

This Special Issue on new developments in the field of IR aims to focus especially on embolizations (emergency and elective settings), oncological treatments and thromboaspirations interventions, running from diagnostic pathways to technical aspects of the procedures and clinical evaluations.

Also, new devices and new applications of already existing devices will be of particular interest.

Dr. Francesco Giurazza
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • emergency
  • oncology
  • arterial
  • vascular diseases
  • extravascular-bleedings
  • aneurysms
  • vascular malformations
  • neurointerventions

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Published Papers (5 papers)

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Research

Jump to: Review, Other

12 pages, 360 KB  
Article
Effective Dose Evaluation of Cerebral Angiography Using Kerma Area Product and Development of Effective Dose Conversion Factors
by Jeongbok Min and Jungsu Kim
Diagnostics 2026, 16(15), 2467; https://doi.org/10.3390/diagnostics16152467 - 5 Aug 2026
Viewed by 234
Abstract
Background/Objectives: Transfemoral cerebral angiography (TFCA) involves significant radiation exposure because of prolonged fluoroscopy and repeated imaging sequences. Because complex dose simulations are often infeasible in routine clinical practice, this study employed PC-based Monte Carlo methods to estimate organ-absorbed and effective doses. The [...] Read more.
Background/Objectives: Transfemoral cerebral angiography (TFCA) involves significant radiation exposure because of prolonged fluoroscopy and repeated imaging sequences. Because complex dose simulations are often infeasible in routine clinical practice, this study employed PC-based Monte Carlo methods to estimate organ-absorbed and effective doses. The primary objective was to establish Kerma area product (KAP)-based conversion factors to facilitate efficient clinical dose assessment. Methods: We analyzed 30 patients who underwent TFCA. Key parameters, including total KAP, tube voltage, and projection angles, were obtained from DICOM Radiation Dose Structured Reports. Monte Carlo simulations were conducted for anteroposterior, lateral, and cranial planes. The conversion factors were then derived by calculating the ratio of the effective dose to the total KAP. Results: The average KAP was 36.23 ± 6.81 Gy·cm2. Effective doses calculated via Monte Carlo simulation were 1.70 ± 0.35 mSv under International Commission on Radiological Protection (ICRP) 60 and 1.90 ± 0.40 mSv under ICRP 103 standards. The corresponding conversion factors were 0.0468 ± 0.0054 and 0.0525 ± 0.0065 mSv/Gy·cm2 respectively. Notably, the ICRP 103-based factor was 12.2 percent higher than the ICRP 60-based factor, reflecting updated tissue weighting factors in modern dosimetry. Conclusions: This study provides standardized conversion factors that allow rapid and reliable dose estimation without requiring complex simulations. The findings demonstrated substantial radiation absorption in the head and neck regions, providing critical data for routine dose monitoring. These results emphasize the importance of rigorous radiation protection and safety protocols during interventional procedures. Full article
(This article belongs to the Special Issue Interventional Radiology in 2025–2026: From Technological Innovation to Clinical Optimization)
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16 pages, 8501 KB  
Article
Angiography-Assisted Cone-Beam CT-Guided Radiofrequency Ablation for Hepatocellular Carcinoma: Single-Center Workflow and Early Outcomes
by Jung Ui Hong, Soon Gu Cho, Kyu Hong Lee, Ji Hoon Noh and Ro Woon Lee
Diagnostics 2025, 15(22), 2898; https://doi.org/10.3390/diagnostics15222898 - 15 Nov 2025
Viewed by 1202
Abstract
Background: Conventional CT- or US-guided radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) often limits repeat contrast-enhanced imaging and provides suboptimal intraprocedural conspicuity, which can hinder precise targeting and margin assessment. Purpose: To describe a single-center angiography-assisted cone–beam CT (angio-CBCT) RFA workflow and report [...] Read more.
Background: Conventional CT- or US-guided radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) often limits repeat contrast-enhanced imaging and provides suboptimal intraprocedural conspicuity, which can hinder precise targeting and margin assessment. Purpose: To describe a single-center angiography-assisted cone–beam CT (angio-CBCT) RFA workflow and report early outcomes versus an institutional conventional CT-guided cohort. Materials and Methods: In this IRB-approved single-center retrospective study, consecutive patients underwent angio-CBCT-guided RFA for HCC (n = 14). Selective intra-arterial injections (≈20–40 mL iodinated contrast per CBCT) through a 5-Fr catheter permitted multiple intraprocedural CBCT acquisitions for targeting, verification, and endpoint assessment under general anesthesia. Primary outcomes were technical success, early local recurrence, and complications (CTCAE v6.0). For a secondary imaging analysis, within-patient change in lesion conspicuity (ΔHU = HU_tumor − HU_liver) from preprocedural contrast-enhanced CT to intraprocedural imaging was compared in available cases (angio-CBCT n = 12; conventional CT n = 13). Descriptive statistics were used. Results: Angio-CBCT RFA achieved technical success in 14/14 (100%) procedures; early local recurrence was 0/14 (0.0%); and one complication occurred (1/14, 7.1%; Grade 3). Intraprocedural refinements included immediate re-ablation in 3/14 (21.4%) and electrode repositioning in 2/14 (14.3%), with on-table detection of an additional lesion in 1/14 (7.1%). In the institutional conventional cohort, technical success was 19/20 (95.0%), early local recurrence 2/20 (10.0%), and complications 0/20 (0%). Lesion conspicuity improved with angio-CBCT (median ΔHU 290.1 HU, n = 12) but not with conventional CT (−10.5 HU, n = 13). Conclusions: Angio-CBCT-guided RFA for HCC is feasible and safe and enables repeatable, low-volume contrast-enhanced intraprocedural imaging that supports precise targeting, verification, and timely refinements. Early outcomes and markedly improved lesion conspicuity suggest potential advantages over conventional CT-guided workflows and warrant prospective validation in larger cohorts. Full article
(This article belongs to the Special Issue Interventional Radiology in 2025–2026: From Technological Innovation to Clinical Optimization)
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Review

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16 pages, 281 KB  
Review
Understanding Current Trends and Advances in Transarterial Radioembolization Dosimetry
by Shamar Young, Kiyon Naser-Tavakolian, Abin Sajan, Stephen Reis, Gregory Woodhead, Tyler Sandow, Juan Gimenez, Kirema Garcia-Reyes, Zachary Berman and Venkatesh P. Krishnasamy
Diagnostics 2026, 16(1), 43; https://doi.org/10.3390/diagnostics16010043 - 23 Dec 2025
Cited by 1 | Viewed by 1903
Abstract
Transarterial radioembolization (TARE) is an established therapy for primary and secondary hepatic malignancies. Outcomes depend heavily on dosimetry, which has evolved from empirical and body-surface-area methods to partition and voxel-based approaches. This review summarizes current evidence for advanced (personalized) dosimetry across tumor types, [...] Read more.
Transarterial radioembolization (TARE) is an established therapy for primary and secondary hepatic malignancies. Outcomes depend heavily on dosimetry, which has evolved from empirical and body-surface-area methods to partition and voxel-based approaches. This review summarizes current evidence for advanced (personalized) dosimetry across tumor types, highlights emerging dose–response concepts, and outlines practical barriers and implementation strategies. A narrative review of peer-reviewed clinical studies and trials evaluating dosimetry in TARE, with emphasis on hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (iCCA), metastatic colorectal cancer (mCRC), neuroendocrine tumor (NET), and breast cancer liver metastases, was performed with comparison of single-compartment medical internal radiation dosimetry method (MIRD), partition (multicompartment) methods, and voxel-based dosimetry methodologies. Personalized dosimetry improves outcomes in multiple tumor types. A randomized trial in HCC showed superior overall survival with partition-based dosing versus MIRD. In selective HCC treatments, voxel-derived metrics (e.g., D95) correlate with complete pathologic necrosis, suggesting benefit beyond mean dose targets. For iCCA, data associate higher tumor doses with better radiologic response, progression-free survival, and downstaging. In mCRC, voxel-based and threshold analyses link specific tumor and margin doses with metabolic/radiographic response and survival. Smaller series in NET and breast cancer indicate dose–response relationships using advanced dosimetry. Evidence supports broader adoption of advanced dosimetry in TARE. Emerging strategies that ensure adequate coverage of the “coldest” tumor regions and thoughtful particle-load planning may further optimize results. Standardized protocols, prospective validation, and scalable workflows are needed to accelerate implementation. Full article
(This article belongs to the Special Issue Interventional Radiology in 2025–2026: From Technological Innovation to Clinical Optimization)

Other

Jump to: Research, Review

7 pages, 792 KB  
Interesting Images
Safe Prostatic Artery Embolization with Cyanoacrylate: Representative Cases Demonstrating Non-Target Artery Preservation
by Antonio Vizzuso, Antonio Spina, Maria Vittoria Bazzocchi, Emanuela Giampalma and Matteo Renzulli
Diagnostics 2026, 16(12), 1785; https://doi.org/10.3390/diagnostics16121785 - 10 Jun 2026
Viewed by 292
Abstract
This study describes five case of prostatic artery embolization (PAE) using n-butyl cyanoacrylate methylsulfone (NBCA; Glubran 2, GEM; Viareggio, Italy) to evaluate its technical advantages, against standard particulate embolization, in managing complex pelvic vascular anatomy while preserving non-target arteries, with particular focus on [...] Read more.
This study describes five case of prostatic artery embolization (PAE) using n-butyl cyanoacrylate methylsulfone (NBCA; Glubran 2, GEM; Viareggio, Italy) to evaluate its technical advantages, against standard particulate embolization, in managing complex pelvic vascular anatomy while preserving non-target arteries, with particular focus on penile artery protection. NBCA was mixed with iodized oil (Lipiodol Ultra Fluid; Guerbet, Aulnay-sous-Bois, France) at 1:5 dilution and injected in small aliquots (0.1–0.3 mL) under fluoroscopy using a blocked-flow technique, with injection stopped at reflux into the horizontal PA segment. After a few seconds, before the complete polymerization of the glue, the microcatheter is quickly withdrawn, flushed, and reused for the contralateral side. NBCA allowed precise embolic control through distinct mechanisms (direct distal, indirect distal, proximal, reflux and controlateral control), avoiding the need for protective coiling. Glue-based PAE seems a reproducible, safe, and efficient alternative to particulate embolization, offering enhanced embolization control and non-target artery preservation in anatomically complex patients. Full article
(This article belongs to the Special Issue Interventional Radiology in 2025–2026: From Technological Innovation to Clinical Optimization)
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19 pages, 3286 KB  
Systematic Review
Tract Sealing Techniques for Pneumothorax and Drainage Prevention After CT-Guided Lung Biopsy: A Systematic Review and Meta-Analysis
by Andrei Roman, Nicoleta-Anca Lobonț-Terec, Roxana Pintican, Bogdan Fetica, Paul Kubelac, Zsolt Fekete, Alexandra Cristina Preda, Andrei Pașca, Călin Schiau and Csaba Csutak
Diagnostics 2026, 16(6), 824; https://doi.org/10.3390/diagnostics16060824 - 10 Mar 2026
Viewed by 1039
Abstract
Background/Objectives: Our goal was to evaluate the effectiveness of tract sealing agents in reducing pneumothorax and chest drainage insertion following CT-guided lung biopsy (CLB), and to assess the certainty of supporting evidence. Methods: A systematic review and meta-analysis were conducted according [...] Read more.
Background/Objectives: Our goal was to evaluate the effectiveness of tract sealing agents in reducing pneumothorax and chest drainage insertion following CT-guided lung biopsy (CLB), and to assess the certainty of supporting evidence. Methods: A systematic review and meta-analysis were conducted according to PRISMA 2020 guidelines (PROSPERO: CRD42024608747). Four health science databases (ScienceDirect, PubMed, Scopus, and Cochrane Library) were searched up to 13 October 2025. Randomized controlled trials and cohort studies reporting tract sealing after CLB were included. Outcomes were post-procedural pneumothorax and pleural drainage insertion. Both were analyzed as dichotomous variables using random-effects meta-analysis with the Mantel–Haenszel method. Statistical heterogeneity was assessed using the I2 statistic. Results were considered statistically significant for p < 0.05. Study quality was assessed using the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2) and the Risk Of Bias In Non-randomized Studies—of Interventions, Version 2 (ROBINS-I V2) tool for cohort studies. Results: A total of 3328 records were initially retrieved, with 37 studies (13,107 patients, 7161 male and 4526 female) meeting the inclusion criteria. Sealing agents included saline solution, hydrogel plug, gelatin sponge, autologous blood patch, saline + rapid roll-over, hemocoagulase, gelatin sponge + hemocoagulase, and fibrin glue. Meta-analysis demonstrated significant reductions in pneumothorax and drainage insertion with saline solution (pneumothorax: OR = 0.35; 95% CI 0.25–0.48; p < 0.00001; drainage: OR = 0.22, 95% CI 0.11–0.43; p < 0.00001), gelatin sponge (pneumothorax: OR = 0.44, 95% CI 0.37–0.53; p < 0.00001; drainage: OR = 0.40, 95% CI 0.29–0.54; p < 0.00001), autologous blood patch (pneumothorax: OR = 0.50, 95% CI 0.40–0.62; p < 0.00001; drainage: OR = 0.40, 95% CI 0.27–0.59; p < 0.00001), and hydrogel plug (pneumothorax: OR = 0.65, 95% CI 0.50–0.85; p = 0.001; drainage: OR = 0.44, 95% CI 0.25–0.76; p < 0.004). Conclusions: Saline solution, hydrogel plug, gelatin sponge, and autologous blood patch are sealing agents that are effective at lowering the risk of pneumothorax and drainage insertion following CLB. Full article
(This article belongs to the Special Issue Interventional Radiology in 2025–2026: From Technological Innovation to Clinical Optimization)
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