Professor Philippe L. Pereira – CIRSE president and director of the Center of Radiology, Minimally Invasive Therapies and Nuclear Medicine at the Academic Hospital of Ruprecht-Karls-University Heidelberg in SLK-Clinics Heilbronn, Germany – talks to Saša Janković about the current challenges and opportunities in interventional radiology in Europe, the drive to inspire holistic and multidisciplinary patient care, and his hopes for the future of the field.
‘Demand is rising for minimally invasive treatments, and we are witnessing incredible growth in interventional radiology, so now is the perfect time for anyone who wants to get involved in the field,’ says interventional radiology (IR) specialist Professor Philippe L. Pereira, reflecting on his experience talking to clinicians and students at the most recent Cardiovascular and Interventional Radiological Society of Europe (CIRSE) Congress held in September.
This year’s CIRSE Congress was a record-breaking event, with nearly 7,000 in-person participants and additional online attendees. For Professor Pereira, who recently began his tenure as CIRSE president, the significant participation of medical students was a promising development.
‘One of our biggest challenges in interventional radiology is awareness among medical students, young clinicians and other medical fields,’ he explains. ‘So, my personal highlight from the Congress was the 480 students from across Europe who registered for the Congress, because getting students involved early will be essential for IR’s continued growth and for meeting patient demand.’
Improving IR recognition, recruitment and training
Despite this ‘exponential increase’ of young medical trainees interested in IR, there is still work to be done to consolidate IR’s position in the clinical landscape and secure its future.
Professor Pereira believes the move to make IR a clinical specialty in its own right is ‘long overdue’, and it is still not formally recognised as a subspecialty in several European countries, including Germany where he is based – a lack of recognition that is impacting recruitment.
‘Potential trainees are still required to complete an entire diagnostic radiology training before specialising in IR,’ he explains. ‘So, although we know that many students would like to pursue a career in IR, they don’t want to go through five years of diagnostic training first, which is proving a barrier to growth, particularly given the high demand for IR procedures.’
Professor Pereira therefore advocates for changes in IR training pathways to streamline the requirements and also to provide trainees with clinical experience in managing patient care beyond the procedure itself. ‘The ideal would be a pathway where aspiring interventional radiologists could undergo a shorter diagnostic training period followed by specialised IR training, ensuring more time for hands-on, patient-centred practice,’ he says. ‘A streamlined training model would mean that interventional radiologists are better prepared to deliver comprehensive care.’
Refining IR approaches
Indeed, while IR has traditionally been seen as a procedural element of diagnostic radiology, Professor Pereira champions a more holistic approach and says that ‘interventional radiologists need to be more clinical’ in their management of patient care.
‘I believe interventional radiologists should oversee patient care from initial consultation through follow-up,’ he says. ‘This longitudinal care model could substantially improve patient outcomes because it’s not enough to perform the procedure; we must see the patient before, during and after treatment.’
Professor Pereira sees the increased engagement from young trainees as part of the solution and it has the potential to herald this new wave of patient-centred care. ‘We’re seeing more young interventional radiologists who focus intently on patient outcomes, and they’re driven by technology, image-guided treatments and artificial intelligence (AI), which is a combination that is transforming what’s possible in IR,’ he says.
Technological advancements shaping the future of IR is something Professor Pereira is particularly excited about. AI and 3D imaging are rapidly advancing the precision of minimally invasive treatments, and new techniques for image-guided tumour ablation, are enhancing the effectiveness of treatments for liver, lung and kidney cancers.
‘These technologies are revolutionising the way we approach complex cases,’ he says. ‘My younger colleagues who grew up with this technology are particularly adept at applying it to clinical practice.’
Best practice and addressing unmet patient needs
Professor Pereira’s own hospital serves as an example of best practice in interventional radiology. Operating with a highly integrated and multidisciplinary team, the hospital was the first in Germany to be awarded IASIOS accreditation. This is a European certification recognising clinical excellence in interventional oncology – the field of IR focusing on minimally invasive, image-guided cancer treatments.
‘This certification doesn’t just assess our ability to perform procedures, it examines our patient pathways, ensuring we work seamlessly with surgeons, oncologists, and other specialists,’ Professor Pereira explains. ‘This coordinated care is essential for addressing complex conditions that require input from multiple experts because when we collaborate, patients benefit and outcomes improve.’
This approach highlights the importance of multidisciplinary collaboration and open communication in addressing complex conditions, such as oncology cases, which often require a combination of surgical, radiological and medical treatments. Professor Pereira believes that broader adoption of multidisciplinary models across Europe could help alleviate unmet patient needs, particularly in oncology.
‘For example, IR treatments for tumours – such as ablation or intra-arterial targeted therapies – allow patients to leave the hospital in days rather than weeks, often resuming normal activities within days,’ he says. ‘One of my recent patients with a liver tumour was discharged two days after treatment and was ready to return to work the following week.’
By reducing hospital stays and facilitating quicker recovery, IR not only benefits patients but also the finances of healthcare systems. Professor Pereira adds: ‘IR is less invasive, reduces complications, and has shown immense value in healthcare cost savings.’
A central role in European healthcare
While Professor Pereira is optimistic about the future of IR across Europe, he says there is still more to be done in order for the field to expand and meet patient demand.
‘It’s essential we build more support for IR at both institutional and governmental levels across Europe. We need greater recognition of IR’s value, not just within healthcare but from society as a whole,’ he says. ‘When we treat a tumour with a minimally invasive approach, the patient goes home sooner, returns to work faster, and the cost to the system is lower – and this is the future of healthcare.’
Further increasing awareness and support of the specialty within the multidisciplinary team is also key, and it’s here that Professor Pereira highlights another potential barrier. He notes that in some areas there is ‘competition’ between IR and surgical disciplines, particularly in cases that could be managed by either specialty.
‘If surgeons and interventional radiologists work together, we can offer more comprehensive care, as each specialty brings different strengths to the table,’ he says. ‘Although I am optimistic that collaboration will improve as newer generations of clinicians embrace multidisciplinary practices.’
With these advancements and collaborations in place, Professor Pereira believes IR could play a central role in European healthcare within the next decade. He says: ‘We’re showing that minimally invasive treatment isn’t just an alternative; it’s often the best option, and by working together across disciplines we can provide patients with a level of care that genuinely improves their lives.’
