Overview of interventional oncology interventional radiology is a subdiscipline of diagnostic radiology. Under the guidance of X-ray fluoroscopy, ultrasound, CT and MRI, interventional radiology uses minimally invasive techniques and instruments such as Seldinger technique, puncture needle, catheter, guidewire and stent to diagnose and treat deep lesions in the body with accurate positioning. It is characterized by small trauma, accurate positioning, safety and effectiveness, and few complications, etc. The rapid development of interventional radiology has enabled interventional medicine to involve a variety of diseases and lesions in all systems of the body in just three decades. Among the various branches of interventional medicine, interventional tumor therapy has the widest therapeutic scope and new technologies are emerging continuously. The integrated use of interventional tumor therapy with surgery, chemotherapy, radiotherapy, biological therapy and traditional Chinese medicine has made a breakthrough in tumor treatment. The treatment scope of tumor intervention covers benign and malignant tumors of various parenchymal organs throughout the body, which can effectively prolong the survival period of patients with intermediate and advanced malignant tumors and improve their quality of life. (1) Interventional treatment via vascular access; (2) Chemoembolization of malignant tumors of parenchymal organs; (3) Arterial catheter cartridge implantation; (4) Vena cava stenting; (5) Pulmonary arteriography and thrombolysis of pulmonary embolism; (6) Inferior vena cava filter placement; (7) Percutaneous variceal vein embolization for portal hypertension (8) partial splenic embolization for hypersplenism; (9) preoperative embolization of resectable tumors and postoperative prophylactic infusion chemotherapy; (10) embolization of uterine fibroids; (11) portal vein embolization/recanalization; (12) thrombolysis, PTA and endovascular stenting (EMS) for arterial and static thrombosis; (13) interventional treatment of non-vascular routes (14) internal and external bile duct drainage and stent placement for obstructive jaundice; (15) radiofrequency ablation of tumors and percutaneous anhydrous alcohol injection therapy; (16) dilation of benign and malignant stenoses of the gastrointestinal, respiratory and urinary tracts and endoprosthesis; (17) percutaneous vertebroplasty and percutaneous kyphoplasty; (18) CT-guided biopsy (thoracic, abdominal and pelvic organs and extremities); (19) (19) abdominal plexus block; (20) tumor-related emergency interventions; (21) DSA angiography diagnosis and interventions for emergency bleeding; (22) emergency interventions for ischemic diseases; (23) transarterial cannulation chemotherapy. The basic method of arterial cannulation chemotherapy is: After local skin infiltration anesthesia at the pulsating femoral artery in the groin, a surgical sharp knife is used to puncture the femoral artery by 2-3mm and the Seldinger method is used to puncture the femoral artery and deliver the catheter. The catheter is inserted into the tumor supply artery, and then the therapeutic drug is infused intra-arterially through the catheter at a dose equal to or less than the intravenous administration of the chemotherapeutic drug. This results in higher local drug concentrations in the tumor cells and prolonged drug contact time with the lesion, and reduces the total systemic drug dose, achieving improved efficacy and reduced side effects. The higher the drug concentration in the tumor site and the longer the drug contact time with the tumor, the better the efficacy of chemotherapy drugs. There are three types of clinical perfusion methods: (1) One-time impact: It refers to the method of injecting the drug into the target artery within a short period of time, and then withdrawing the tube to end the treatment. It is characterized by rapid operation, few complications and simple care, and is suitable for sites where catheter retention is difficult. (2) Arterial block chemotherapy: It is a method of inserting a blocking balloon catheter into the target artery, then causing the balloon to expand to block the arterial blood flow, and then infusing chemotherapy drugs. The purpose is to further increase the drug concentration and prolong the drug arrest time. (3) Long-term drug perfusion: This method leaves the catheter in place for a longer period of time, and the perfusion can be continuous for several times. Trans-arterial embolization therapy A solid or liquid substance is selectively injected into tumor blood vessels and tumor blood supply arteries through catheter to block tumor blood supply and inhibit tumor growth. For tumors that cannot be removed surgically, this therapy can shrink the tumor and reduce the pain and other complications to achieve the purpose of delaying life and improving the quality of survival. Types of embolic agents: (1) solid embolic agents: mainly gelatin sponge, polyvinyl alcohol (PVA), etc. (2) Liquid embolic agents: iodine oil, anhydrous alcohol, Chinese medicine preparation, etc. Among them, iodine oil disappears after several days in normal tissues after arterial injection, but stays in tumor tissues for a long time, which can reach several months or more than one year. Iodine oil and anti-cancer drugs are made into emulsion or suspension for tumor embolization treatment, which is called transcatheter intra-arterial chemoembolization. iodine oil acts as a carrier of anti-cancer drugs, so that the drugs can stay in the tumor for a long time with high concentration and release slowly, which increases the anti-cancer effect of the drugs; at the same time, it blocks the blood supply to the tumor, and TACE becomes the main way of interventional treatment for tumors with rich blood supply. 3.Arterial cassette catheter implantation Arterial cassette catheter system implantation is to insert a histocompatible cassette catheter into the tumor blood supply artery by Seldinger technique and then implant the catheter with a small cavity in the extravascular end of the cassette under the skin to provide a long-term safe and reliable vascular access for the infusion of chemotherapy drugs, blood products and nutritional support for malignant tumor patients. However, it is mainly used for the arterial infusion chemotherapy of abdominal and pelvic malignant tumors, such as liver tumors, kidney tumors, ovarian tumors, uterine tumors, bladder tumors, etc. The method can also be used for long-term arterial infusion chemotherapy of tumors supplied by extremities and external carotid arteries. The main reasons are: 1. The interventional method of drug cartridge implantation makes the drug cartridge implantation more convenient and safe; 2. It not only greatly reduces the amount of X-ray radiation received by both doctors and patients during the interventional operation, but also saves the medical cost of multiple intubations for patients. 4.Vena cava stent placement (1) Tumor stenosis and obstruction of inferior vena cava: abdominal tumors such as primary liver cancer and metastatic liver cancer often cause stenosis and occlusion of inferior vena cava due to tumor compression, because of stenosis or occlusion of inferior vena cava, venous return obstruction of lower extremities, pelvis and abdomen, clinically patients appear varicose veins of chest and abdominal wall and lower extremity edema, involving the hepatic vein or above the opening of hepatic vein, then portal vein (2) Tumorigenic superior vena cava syndrome, such as hepatosplenomegaly, hepatic impairment, abdominal pain, abdominal distension, ascites, varices in the lower esophagus, and upper gastrointestinal bleeding in severe cases. (2) Tumor superior vena cava syndrome: Tumor superior vena cava syndrome is a group of syndromes caused by complete or incomplete superior vena cava obstruction caused by various reasons, resulting in obstruction of blood flow. The typical clinical symptoms and signs are congestion and edema of the face, neck, upper extremities and upper chest, and conjunctival edema of the eyes, as well as dyspnea, cough, chest tightness and chest pain. It is often life-threatening and requires timely management. According to statistics, 97% of patients with superior vena cava syndrome have cancerous tumors, 75% of which are lung cancer. The incidence of superior vena cava syndrome in patients with lung cancer and malignant lymphoma is 3-8%. Interventional treatment of superior vena cava syndrome and inferior vena cava stenosis and obstruction Balloon catheter angioplasty (PTA) and internal stent placement for stenosis or occlusion of the superior and inferior vena cava can achieve better clinical results. 5.Percutaneous percutaneous hepatic variceal vein embolization for treatment of portal hypertension esophagogastric fundic varices Chronic liver disease cirrhosis is mostly secondary to portal hypertension, and bleeding from ruptured esophagogastric fundic varices is one of the main causes of death in cirrhotic patients. Portal hypertension is further aggravated by the development of portal vein thrombosis in patients with hepatocellular carcinoma, and ruptured bleeding from esophagogastric fundic varices in patients with hepatocellular carcinoma makes the situation even more dangerous. Percutaneous percutaneous hepatic variceal vein embolization is a method to treat portal hypertension gastroesophageal variceal bleeding by percutaneous puncture of intrahepatic portal vein branches and embolization of gastroesophageal varices. A series of studies have confirmed that PTVE has significant efficacy in controlling acute bleeding and reducing morbidity and mortality, and that PTVE combined with splenic artery embolization or left gastric artery embolization results in a 100% hemostasis success rate and a 6.7% rebleeding rate at 1 year after embolization. It also increases the 1-month survival rate from 37% to 73% with conservative medical treatment. 6.Partial splenic embolization for hypersplenism: portal hypertension can be secondary to hypersplenism, especially in cirrhotic portal hypertension. Most of our patients with liver cancer have cirrhosis, secondary to hypersplenism, which leads to one or more kinds of blood cell reduction with serious consequences. Surgical splenectomy often results in decreased immune function of the patient and is prone to complications of infection and bleeding. Interventional therapy partial splenic embolization has been considered as the preferred method of hypersplenism treatment. 7, uterine artery embolization for uterine fibroids: Uterine fibroids are benign tumors originating from the smooth muscle of the uterus, with an incidence of up to 20%-40% in women over 30 years of age. Patients may present with symptoms of pressure such as heavy menstruation, abnormal uterine bleeding, lower abdominal pain, masses or frequent urination and constipation. In recent years, uterine artery embolization has become one of the treatment of choice for symptomatic uterine fibroids in developed countries in Europe and the United States. The technical success rate of uterine artery embolization is 98%-100%. According to the American Society of Cardiovascular Interventional Radiology (SCVIR) in 1998, the overall recent efficiency of uterine artery embolization for uterine fibroids was 90%, with an average reduction in fibroid volume of 50% and an average reduction in uterine size of 40%-60%. The menstrual volume was significantly reduced in 90% of cases, and the pressure symptoms disappeared. 8, obstructive jaundice bile duct internal and external drainage and stent placement: malignant obstructive jaundice, mostly due to cholangiocarcinoma, primary liver cancer, pancreatic cancer and hepatoportal lymph node metastasis compression or invasion of the bile duct, the patient jaundice progressive aggravation, and secondary infection and liver failure and liver and kidney syndrome. If left untreated, the patient dies within a short period of time. In recent years, a new interventional technique of percutaneous intrahepatic biliary stent placement has emerged at home and abroad, namely, percutaneous puncture of the intrahepatic bile duct and placement of the stent at the site of bile duct obstruction, so that the stagnant bile enters the duodenum through the original physiological channel. The main advantages of this technique are: 1, minimally invasive, 2, high patency rate, 3, maintenance of the original physiological channel, 4, less susceptible to infection and easy care. The success rate of endobiliary stenting is 90%-96%, and the jaundice regression rate is 85%-95%. Endobiliary stenting can alleviate the disease, improve the patient’s general condition, and gain the opportunity for the treatment of primary lesions (such as TACE for hepatocellular carcinoma, internal radiation therapy, second-stage surgical resection, etc.). 9.Tumor radiofrequency ablation and percutaneous anhydrous alcohol injection therapy Tumor radiofrequency ablation refers to a minimally invasive treatment method under the guidance of medical image, which is to deepen the ablation electrode into the tumor tissue percutaneously and use the physical principle of high-frequency current to convert it into heat energy in the treatment area, so as to achieve the purpose of destroying the tumor and even eradicating it. Its characteristics are minimally invasive, precise efficacy and small side effects. Radiofrequency ablation of tumors is widely used in the treatment of many solid tumors, such as liver tumors, lung tumors, mediastinal lymph nodes, kidney, adrenal tumors, prostate tumors, and has also been reported in the treatment of osteoid osteoma, chordoma and tumor bone metastasis. Percutaneous anhydrous alcohol injection is used to cause coagulation and necrosis of tumor tissues in the area of anhydrous alcohol injection by using the principle that anhydrous alcohol can denature proteins. After 1-2 times of transarterial catheter chemoembolization (TACE) for hepatocellular carcinoma, RFA or PEI is performed, which fully protects liver function while intensifying treatment and improves the quality of life and long-term survival of patients. 10.Dilatation and endoprosthesis for benign and malignant stenosis of the digestive, respiratory and urinary tracts The etiology of stenosis of the digestive, respiratory and urinary tracts includes: tumoral stenosis, post-radiotherapy stenosis, postoperative anastomotic stenosis, scar contracture, and external pressure stenosis. Interventional treatment of the above-mentioned luminal stenoses includes balloon dilation and endoprosthesis. Closure of the fistula with an overlapping stent can be twice as effective. Interventional treatment can immediately relieve the symptoms of luminal stenosis, improve the patient’s vital signs, improve the quality of life, and gain time for further treatment. 11, percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) Percutaneous puncture vertebroplasty is a technique for treating osteolytic bone destruction and osteoporosis by percutaneously puncturing the cervical, thoracic, and lumbar vertebrae and infusing them with filling material under the guidance and surveillance of imaging equipment to enhance the strength and stability of the vertebral body, prevent collapse, and relieve low back pain. Percutaneous kyphoplasty is a minimally invasive spinal procedure developed in recent years on the basis of PVP, which not only enhances vertebral body strength but also restores vertebral body height, thus enabling correction of kyphotic deformity due to vertebral body compression. (1) T-guided puncture biopsy (thoracic, abdominal, pelvic organs and extremities); (2) CT-guided puncture biopsy is an important tool for tumor diagnosis.