Interventional radiology (IR) departments diagnose and treat disease. IR professionals treat a wide range of conditions in the body by inserting various small devices, such as catheters or wires from outside the body. X-ray and imaging methods, such as CT and ultrasound help guide the radiologist. Interventional radiology can be used instead of surgery for many conditions. In some cases, it can eliminate the need for hospitalization.
ICE Magazine reached out to leaders in diagnostic imaging and IR to find out more about the modality and to share those insights. Participants in this month’s Director’s Circle article on interventional radiology are:
- Michelle Bourns, RT(R), interventional radiology manager, Parkland Health;
- Ken Gleeson, MBA, RT (R) (VI), system manager, interventional radiology, University Hospitals; and
- Alpana Patel Camilli, BS, CRA, (R) (CT), manager, interventional radiology and neuroendovascular surgery, UCSF.
Q: How do you assess and integrate new technologies or techniques into your practice?
Bourns: New devices and methods are trending in the interventional radiology world. Our physicians and technologist stay current by attending conferences and completing hands-on workshops. Often these workshops are hosted directly within our IR department to allow maximum exposure to our frontline staff that may not have the opportunity to attend outside conferences. This also allows physicians to fully test and evaluate devices before they are used in clinical practice.
Gleeson: Technology moves so quickly in health care it seems there is always something new on the horizon. When deciding whether to invest in new technologies, it is best to follow a tried-and-true method that includes the following steps:
- Thoroughly assessing what is needed, what problems will be solved and what the benefits are to patients and staff.
- Compare the options available – contact vendors, setup demonstrations, decide which option is best.
- Plan for implementation including staff education and training.
- Track and evaluate outcomes.
- Re-assess and adjust.
Patel Camilli: At UCSF Health, we systematically assess and integrate new technologies by prioritizing cutting-edge solutions that elevate patient care and address complex cases. With the recent acquisitions innovative ablation units, we are enhancing our precision treatment capabilities, especially for patients with challenging tumor presentations. We also stand ready to deploy advanced techniques, such as histotripsy, HIFU, LIFU ensuring our patients benefit from non-invasive, high-impact therapies. By the time patients reach UCSF, they have often exhausted conventional options – our approach focuses on offering innovative, minimally invasive alternatives tailored to deliver better outcomes
Q: How can interventional radiology better collaborate with other specialties to improve patient care?
Bourns: Working closely with other specialties allow for a more comprehensive approach for treatment. IR is part of a larger treatment team that includes oncology, cardiology, vascular surgery and urology – to name a few. Creating process improvement committees, task forces and multidisciplinary tumor boards provide a platform to showcase advanced techniques utilized in IR. A great example of collaborative care in IR would be a patient receiving treatment for neuro aneurysm coiling procedure then proceeding to OR for an aneurysm clipping procedure. Another example would be a patient with liver cancer receiving chemoembolization in the IR suite then systemic therapy from the oncologist. The multidisciplinary approach can decrease length of stay and provide better patient outcomes.
Gleeson: Interventional radiology can better collaborate with other specialties by taking part in team meetings, providing education to referring physicians as to what treatment options offered by IR may be right for their patients and by getting involved in shared clinical trial and research opportunities. Ideally, interventional radiology would develop and distribute evidence-based referral guidelines that could be shared with physicians across the various specialties. Sharing of an electronic medical record (EMR) helps ease communication between physicians and ensures everyone has access to the same information.
Patel Camilli: Interventional radiology at UCSF actively fosters cross-specialty collaboration through structured partnerships with oncology, neurology, hepatology and cardiology. By participating in multidisciplinary conferences, including tumor boards, we streamline complex case management, ensuring every specialty aligns on the best course of action. Our IR suite also integrates scheduling with these specialties, reducing bottlenecks and ensuring procedures are performed with urgency. We are committed to demonstrating the unique value of IR, educating referring physicians, and offering advanced tools to complement traditional treatment pathways.
Q: What challenges do you see in training the next generation of interventional radiologists?
Bourns: The interventional radiologist is a resource for many specialties to seek advice and support for treatment plans for low- and high-acuity patients. The field of IR continues to evolve with technology, imaging techniques and medical devices. Physicians need to train on the latest technology to provide the best of care. This advancement of technology comes with a price and can be challenging for any organization to financially support the advancement in real time. The team must balance providing the best outcomes with older traditional techniques, while trying to keep pace with emerging technologies both educationally and financially.
Gleeson: One of the biggest challenges on training the next generation of interventional radiologists is the nationwide shortage of IR attendings. This forces the existing IR attendings to be spread thinly across coverage areas within their health systems, potentially making them less available to mentor their Fellows and Residents.
This also contributes to physician burnout which affects the training experience of future IR physicians. Another challenge is the migration of several types of interventional procedures away from IR such as PE thrombectomies, peripheral artery disease interventions and other procedures that will limit the future IR physicians exposure to the full range of procedures needed for comprehensive training.
Patel Camilli: One of the biggest challenges in training future interventional radiologists lies in balancing the demands of clinical service with hands-on learning, especially as procedures become more specialized. Exposure to complex, high-acuity cases is essential, but it demands a structured learning environment to ensure both quality care and trainee competency. Additionally, future radiologists need advanced communication skills to effectively manage multidisciplinary teams and provide empathetic care to patients who have already undergone multiple interventions. Rapid technological advances require a dynamic training curriculum to keep trainees fluent in both new technologies and evolving clinical protocols.
Q: What best practices have you implemented to improve the operational efficiency of your interventional radiology suite?
Bourns: Improving operational efficiency in IR is very important not only for high-quality patient care but for frontline job satisfaction. Three areas we focused on were:
- On-time starts
- Room turnaround time
- Employee engagement
We improved on-time starts 25% by standardizing orders, establishing tasks for providers and streamlining the preoperative process. We improved turnaround time 50% by working with clinical engineering to optimize the timing for equipment repairs and partnering with EVS to improve communication and reduce redundancies in the cleaning process. We improved employee engagement scores to the top decile by increasing frequency of one on ones, established daily multidisciplinary team huddles, and involved the team in goal setting.
Gleeson: Best practices applied to operational efficiency in IR suites would include the required use of a robust electronic medical record that provides critical data. This data can then be used to create benchmarks and KPIs to help find optimal workflows by identifying opportunities and deficiencies. Analysis of correct data helped to improve staffing of techs and nurses in the procedural areas as well as the pre- and post-procedural area. The use of “wearable” communication devices dramatically improved the efficiency of communications between team members. The implementation of a pre-procedure brief prior to each case helped reduce “wrong site, wrong side” situations and ensured that any special tools or equipment were available before beginning the procedure.
Patel Camilli: We have implemented standardized workflows, lean protocols, and real-time monitoring of performance metrics to ensure our IR suites operate at peak efficiency. With cross-training initiatives for both body and neuro IR, we’ve optimized staffing across campuses to adapt seamlessly to fluctuating caseloads. The adoption of specific treatment units/equipment allow us to streamline high-precision tumor ablation procedures, minimizing downtime and maximizing throughput. Daily team huddles and predictive analytics tools ensure we proactively address scheduling, labor, and resource challenges, reducing delays and enhancing patient flow.
Q: What other insights can you share with ICE Magazine regarding interventional radiology?
Bourns: Like many health care professions, IR has faced shortages. Burnout with IR technologist can be a real concern. The expectations set for an IR technologist can be overwhelming and intimidating. As leaders, we can be proactive and prevent this from occurring. Allowing flexible scheduling between the team gives some control back to the individual. We work hard to provide our team a psychologically safe environment where they feel empowered to speak up when they have concerns. We ensure they feel confident in their skills set by providing personalized training utilizing flow models.
Gleeson: Interventional radiology has come a long way from its beginnings, appearing as a cornerstone of modern, minimally invasive medicine. With its expanding role in oncology, neurology, and beyond, as well as its ability to integrate with innovative technologies like AI and robotics, IR is poised to continue playing an increasingly pivotal role in patient care. As the field adapts to these innovations, the next generation of interventional radiologists, administrators, IR techs and IR nurses will need to embrace both technical proficiency and interdisciplinary collaboration to continue improving patient outcomes in the future.
Patel Camilli: At UCSF, we are redefining the role of interventional radiology by embracing cutting-edge technologies that enable us to treat patients beyond the limits of traditional approaches. Our IR program emphasizes patient-centered care by focusing on outcomes that matter – reduced recovery times, fewer complications and highly personalized treatment plans. We recognize that innovation is not just about technology but also about leadership, which is why we invest in developing future IR leaders who can seamlessly blend clinical expertise with operational excellence. With a commitment to remaining at the forefront of precision medicine, UCSF IR continues to set new standards, ensuring our patients receive the best possible care when they need it most and our goal is to be just in time!
