Radiology department in modern medicine is not only limited to diagnostic imaging. It has well established role in therapeutic aspects. In cancer related conditions radiology offers diagnostic imaging, minimal invasive procedures to obtain tissue for biopsy and multiple therapeutic interventions. Department of diagnostic and interventional radiology at Nepal Cancer hospital has been providing multiple advanced imaging and interventional radiological services along with routine imaging through five units which are
- X-Ray Unit:
- This unit is equipped with modern advanced X-Ray system ie. Both Computerized Radiography (CR) System as well as Direct Digital Radiography System(DR)
- Namely, Philips Primary Diagnost DR, Agfa 15X Drystar
- Ultrasonography Unit:
- This unit is equipped with modern advanced equipment and providing services through highly trained Radiologists and USG service Trained ANMs.
- Unit is equipped with modern state of art equipment like, Medisonaccuvix XG usg, Mindray DC80 with needle visualization software and One medisionsonoacer R3 portable unit for portable /bedside services
- Mammography Unit:
- This unit is equipped with modern advanced Mammography system ie. Direct Digital Radiography (Mammography) System (DR).
- Namely SemiensMammostat DR with autocups technology
- Supplied with many supporting segments which are very helpful for mammo guided invasive procedures accurately like FNAC, Biopsies.
- CT Scan Unit:
- This unit is equipped with modern advanced CT Machine (SemiensSomatom AS- 20 slice).
- Wide bore, which is very helpful for radiation simulation during RT as well as very easy and comfort during CT guided invasive procedures like FNAC, Biopsies
- In NCHRC, all CT scan images are kept in department record as cancer lesion needs to be compared to evaluate the response to therapy.
- Interventional radiology clinic;
- Separate OPD basis consultation Room
- Services providing through this clinic are Counseling to the patients and patients party regarding interventional radiology services, their complications, preparations, and after care by Radiologist themselves, and well trained staffs.
Apart from the common diagnostic services the department has been providing many advanced diagnostic and interventional services which includes:
- Elastography: It is medical imaging modality that maps the elastic properties of soft tissue. The main idea is that whether the tissue is hard or soft will give diagnostic information about the disease. Cancerous tissues are often stiffer than the surrounding normal tissue. In our institution ultrasound elastography is done specially for breast lesions.
- Biopsy: At NCHRC, FNAC is routinely perform with ROSE (rapid on-set evaluation) technique in which pathologist confirms the adequacy of sample on site so that patient will not have to come again for re-FNAC in case of inadequate tissue sampling. Routinely we make cell block out of the biopsied material as well. In case of solid organ lesions, the department is doing TRU-CUT biopsies in which multiple cores of tissues using co-axial technique, there is no need of multiple punctures to obtain multiple cores of tissue.
- Intra thoracic/Intra-abdominal fluid collection management: Since pleural effusion and ascites are one of the most common presentations in oncology. Image guided drainage provides little discomfort and precise localization. Pigtail catheter insertion is also done if prolonged drainage is indicated.
- Biliary interventions: In cancer related to biliary system, obstructive bilopathy is common problem. The department offers procedure like percutaneous transhepatic biliary drainage (PTBD) using standard catheters including both external drainage and internal drainage. Brush cytology, punch biopsy and biliary stenting are also offered.
- Needle localization in breast lesions: Special needle is anchored into the breast lesion for the proper localization of the lesion in breast conserving surgery and neo-adjuvant therapy.
- Trans-catheter Therapeutic Procedures: In oncology there are several indications of targeted therapy. These advance services like TACE has been provided in NCHRC routinely. Cancer cases also present with severe bleeding in which embolization can be lifesaving which is also available at NCHRC.
- IVC filter placement: Cancer patients suffer from deep venous thrombosis which can lead to pulmonary thromboembolism. To prevent pulmonary thromboembolism IVC filters can be placed under radiological guidance. Other vascular interventions including venous and arterial stenting are also performed in NCHRC
- Microwave Ablation technique: NCHRC is the only center in Nepal where microwave ablation technique has been started for treatment of cancer. In this technique under image guided small needles which emit microwaves are inserted into the tumor and tissues are ablated. The procedure is done on daycare basis and no significant discomfort is experienced by the patients.
- Radiologically Inserted Percutaneous Gastrostomy (RIG): Patient suffer feeding difficulties in many cancerous conditions. Feeding can be established by inserting a small tube directly into stomach without major surgery. Such procedure is being practiced in NCHRC.
- USG Guided PICC line
- Other non oncology Interventional procedures
- Participation on multidisciplinary tumor board.
Diagnostic and Interventional Radiology Team
At NCHRC, a team of highly qualified registered medical professional is taking care of patients for accurate diagnosis of diseases using highly advanced medical imaging equipment. The team is led by qualified and experienced sr. consultant radiologist/H.O.D. Dr.Saroj Prakash Chataut.
Other members of the team are:
- Consultant Interventional Radiologist – 1
- Radiologist – 2
- Incharge/Sr..Radiologic Technologist – 1
- Visiting interventional radiologist –1
- Visiting radiologist – 1
- Radiographer – 6
- ANM/CMA – 4
- Administrative Assistant /Receptionist/Report Typist – 5
- Attendant – 2
- Academic Activities:
- Academic courses PCL in Diagnostic Radiography, BMIT.
- Extending Research Activities
- Providing platform for short-term training/internship being specific in oncology related radiology services.