Interventional Radiology & Imaging Center


Group Florence Nightingale Hospitals Center for Interventional Radiology was awarded the “TheraSphere Center of Excellence” certificate in May 2016 with in the field of treatment with TheraSphere Yt-90 Radioembolization in liver tumors, an important application in interventional radiology.

Versatile and rigorous work of the expert team in radioembolization applications was awarded with ‘’Center of Excellence’’ certificate which is granted for only few centers in the world. In previous years, Northwestern Memorial Hospital/Chicago USA, Mount Sinai Hospital/New York-USA, University of Essen/Germany, Istituto Tumori/Milano-Italy and Centre Eugene Marquis/Rennes-France hospitals have been also entitled to receive this certificate. Thus, the superior service quality of our Interventional Radiology Center has been registered worldwide.

This certificate allows us to grant certificates to the physicians participating the domestic and international education and training programs at Center for Interventional Radiology.


What are fields of interest of the Interventional Radiology?


Diagnosis and treatment of vascular diseases


Diagnosis of vascular obstruction such as vascular stiffness (atherosclerosis) and vasculitis (vein inflammation) by angiography and treatment with balloon angioplasty and/or stent is provided.

At our Center, it is possible to treat hemangioma (vascular ball) and vascular malformations (AVM) with angiography by embolization. Also, aneurysms of the brain (bubbles), aneurysms of the limbs (limb), aneurysms of the vessels of the internal organs (visceral aneurysms) and the main artery, aortic aneurysms, without the need for surgery, can be treated with embolization or special stents (endograft, cover stent, current-leading stent, etc.) accompanied by angiography.

At our Center, where leg varicose veins can be treated with laser, without surgery, other methods of diagnosis and treatment are listed as follows:

  • Angiography of legs and lower extremities,
  • Carotid, vertebral, brain and spinal angiography,
  • Angiography of the arm (upper limb),
  • Pulmonary (lung) and bronchial angiography,
  • Renal (kidney) angiography,
  • Angiography of mesenteric vein (intestinal vessels),
  • Celiac, hepatic (liver) angiography,
  • Angiography of the thoracic aorta, abdominal aorta,
  • Aortic aneurysm (non-surgical treatment with endograft),
  • Aneurysm of peripheral and visceral arteries,
  • Non-surgical treatment of brain aneurysm
  • Hemangioma,
  • Hemangioma of the liver,
  • Venous malformations,
  • Arteriovenous malformations (AVM)
  • Lymphangioma,
  • Lymphocele, lymphocyst,
  • Treatment of peripheric artery disease, stent-balloon angioplasty,
  • Carotid obstruction, treatment with stent, carotid stent
  • Leg vascular obstruction (atherosclerosis, Buerger’s disease, diabetic foot),
  • Mesenteric ischemia, mesenteric thrombolysis,
  • Renal artery stenosis, renal artery stent,
  • Laser treatment of varicose veins,
  • Deep vein thrombosis
  • Pulmonary embolism,
  • Vena cava filter,
  • Peripheral and central vein pathway (PICC)
  • Central venous catheter (tunnelled and without tunnels)
  • Treatment of varicocele without surgery,
  • Priapism-High Flow Priapism
  • Removal of foreign bodies,
  • Renal vein blood sampling-Renal venous sampling
  • Adrenal vein blood sampling-Adrenal venous sampling
  • Parathyroidism vein blood sampling-Parathyroidism venous sampling
  • TIPS-Transjugular Intrahepatic Portosystemic Shunt
  • Hemodialysis fistula treatment,
  • Venous stenosis – obstruction stent.

Diagnosis and treatment of hemorrhages


Treatment of life-threatening hemorrhages by endovascular (intravenous) embolization is among the important methods of interventional radiology.

Immediate treatment of hemorrhages in the gastrointestinal tract, lungs, vaginal, brain and internal organs, traumatic and post-operative bleeding is also life-saving. In this context;

  • Gastrointestinal bleeding, embolization,
  • Pulmonary hemorrhages, hemoptysis, embolization,
  • Traumatic hemorrhages, embolization,
  • Postoperative hemorrhages
  • Bladder and prostate bleeding
  • Vaginal hemorrhages,
  • Brain hemorrhage, brain aneurysm, brain AVM, subarachnoid hemorrhage,

• Hemorrhages in organs such as liver, kidney and spleen are precisely diagnosed and successfully treated.


Treatment of urinary tract obstruction


Ultrasonography (USG), computed tomography (CT) or nephrostomy under scopy in urinary tract obstruction is of great importance for maintaining kidney health, especially in children and infants. It is more important for the patients with kidney transplant story. In this context;

  • Nephrostomy
  • Ureter stenting
  • Pediatric nephrostomy applications are performed.

Treatment of uterine fibroids without surgery


In uterine fibroids, treatment with embolization, RF ablation and HIFU ablation is possible as an alternative to the surgery. Treatment methods of uterine fibroids without surgery is listed as follows;

  • Embolization of uterine fibroids
  • Myooma RF ablation
  • Treatment of fibroids with HIFU.

Treatment of osteoporosis-vertebra without surgery


Bone cement is injected into the collapsed vertebrae under computed tomography (CT) and/or scopy in the spine (vertebrae) collapses due to bone meltdown, trauma, and tumor. Thus, it is aimed at strengthening the spine, preventing the possible pressure on the spinal cord. In this context;

  • Kyphoplasty,
  • Vertebroplasty treatments may be applied.

Treatment of prostate growth (hypertrophy) without surgery


In recent years, problems such as having difficulty urinating due to prostate growth (benign prostatic hyperplasia) and thamuria at night may be cured without a surgery. By angiography, embolization (prostate artery embolization) is performed, the prostate is reduced and pressure on the lower urinary tract is prevented. Nonsurgical methods include;

  • Embolization of the prostate artery
  • Prostate HIFU.

Treatment of biliary tract obstruction


Bile ducts obstructed due to cancer, postoperative complication or stones, disrupt liver function and damage the brain and kidney. Elevation of bile in the blood leads to a disruption of chemotherapy.

Within the scope of interventional radiology applications, a plastic inserted into the biliary tract and bile duct is removed with a thin catheter and the level of bile in the blood is lowered. In this method of treatment called “percutaneous biliary drainage”, the clogged segment can be opened with a balloon and/or stent apart from drainage,.

For the treatment of biliary obstruction, the following methods are applied:

  • Biliary drainage (percutaneous biliary drainage)
  • Biliary tract stent (percutaneous biliary stent)
  • Biliary tract balloon dilatation (percutaneous biliary balloon dilatation)
  • Bile tract RF ablation

Diagnosis and nonsurgical treatment of thyroid nodules


Taking a sample from the thyroid nodule with a very thin needle under ultrasound (USG), and examining the sample histopathologically determines 95% whether the nodule has cancer. Non-cancer nodules can also be burned with a thin needle using the “Thyroid Nodule RF Ablation” method. RF Ablation, which refers to non-surgical intervention, leaves no traces on the neck and prevents the patient from being dependent on thyroid medicine afterwards.

  • Benign (bening) thyroid nodule,
  • Recurrent, inoperable malignant thyroid nodules,
  • Recurrent, inoperable lymph nodes can be treated with this method.

Nonsurgical reatment of obesity


Embolization of the fundus artery of the stomach instead of surgery in patients with a certain degree of obese (bariatric embolization); reduces the release of the appetite hormone “ghrelin” and helps the patient to lose weight. Minimal complications compared to gastric surgery is considered the primary advantage of this method of treatment.

  • Bariatric embolization
  • Embolization of the left gastric artery

• Embolization of the stomach artery may be performed with this method.


Drainage of abscesses – aspiration of the cyst


Abscesses in the abdomen and lung membranes, kidney cysts and hydatid liver cyst (dog cyst) treatment can be treated with aspiration-irrigation or catheter drainage.

  • Abscess drainage of the abdominal cavity,
  • Drainage of pelvis abscess,
  • Drainage of lung abscess,
  • Pleural effusion drainage and aspiration,
  • Aspiration of ascite/abdominal fluid/ascites drainage
  • Aspiration of the kidney cyst and sclerotherapy,
  • Liver cyst aspiration and sclerotherapy,
  • Hydatititid/Dog cyst/Parasitic liver cyst may be treated with this method.

CANCER TREATMENT


“Locoregional cancer treatment”, targeted treatment, comes to the fore every day.

In the modern approach to oncological treatment, interventional oncology occupies an important place. With targeted chemoembolization, radioembolization and tumoral ablation, the chances of destroying cancerous tissue are increasing.

Interventional oncology is the focus of new technological treatment methods that can be used to reach cancerous tissue and carry out targeted treatment.

Applications in the field of diagnosis and treatment of interventional oncology are listed as follows:

  • Liver cancer (cirrhosis related cancer, hepatocellular carcinoma-HCC)
  • Hepatic metastases (breast, large intestine (colon), pancreas, stomach, lung, neuroendocrine, etc. metastases to the liver)
  • Cholangiocarcinoma (biliary tract cancer)
  • Kidney cancer
  • Pancreatic cancer
  • Lung cancer
  • Bone cancer and bone metastases
  • RF ablation
  • MW Microwave ablation
  • Cryo ablation
  • IRE ablation
  • HIFU ablation
  • Radioembolization, microsphere therapy, Yt-90
  • Chemoembolization
  • Chemosaturation, PHP
  • Pancreatic biopsy
  • Liver biopsy
  • Kidney biopsy
  • Lung biopsy
  • Thyroid biopsy
  • Bone marrow biopsy
  • Bone vertebrae biopsy
  • Lymph node biopsy
  • Breast biopsy

Chemoembolization


Chemoembolization, which is being successfully applied at the Center for Interventional Radiology of the Group Florence Nightingale Hospitals, is a special embolization method performed with microspheres charged with chemotherapy drugs expresses. With this treatment, it is aimed to block the vessels that feed cancer (embolization) and to give chemotherapy drugs directly into the cancerous tissue.

Microspheres loaded with chemotherapy drugs remain in the cancerous tissue, gradually releasing the drugs. The procedure helps the cancerous tissue to remain under the influence of high doses of chemotherapy for a long time. Thus, chemotherapy drugs do not spread throughout the body, but remain only in the tumor.

Chemoembolization is generally the first preferred treatment method for liver cancer (HCC, cholangiocarcinoma). In addition, it is preferred every day in liver metastases which are inoperable or do not respond to systemic classical chemotherapy. Scientific studies also show that the proven effectiveness of this treatment, increases the quality of life and duration.

Tumor ablation


Tumor ablation under general anesthesia is applied in the form of energizing by entering cancer tissue with a special needle accompanied by computed tomography (CT) and/or ultrasonography (USG). By the heat exchange of hot or cold heat generated with this energy, cancer tissue thermally damaged. Thus, the death of cancer cells occurs by burning or freezing. Tumor ablation, which does not require an incision, is done by entering through the skin as it is not a surgical method.

The main types of ablation therapy at our center are:

  • RF Ablation
  • MW Ablation
  • Cryo Ablation
  • IRE Ablation
  • HIFU Ablation.

Radioembolization


Group Florence Nightingale Hospitals Center for Interventional Radiology, stands out for the fact that it is among the 6 hospitals in the world by generating solution with radioembolization in patients with liver cancer and liver metastases that can not be cured with surgical treatment and chemotherapy.

This treatment, which uses high technology, is carried out with a disciplinary approach by experts, experienced interventional radiology and nuclear medicine experts working at our center. Our experts are also giving hope to our international patients with their knowledge and experience.


Radioembolization with Holimum 166 in the treatment of liver cancer


Radioembolization is carried out by injecting microspheres with radioactive substances into the cancer tissue through the vessels feeding cancer. Locoregional-local treatment method  does not have systemic effects that spread throughout the body, as chemotherapy does. Therefore, the lack of side effects associated with radioembolization is noted as its most important superiority while using the radioactive substances to cure liver cancer and liver metastases.

Radioembolization therapy, successfully applied in the world for inoperable advanced liver cancers and metastases, does not delay the systemic treatment and chemotherapy of the patient, as well as some can be administered simultaneously with systemic therapy and chemotherapy.

Radioembolization therapy previously performed with radionuclide “Yitrium 90”, is now carried out with a new agent “Holmium 166”  in our country for the first time after the Netherlands, Germany and Italy, with a joint study of the departments of Interventional Radiology and Nuclear Medicine


Interventional oncology


“Interventional oncology”, which has entered our lives as a result of the development of new technological methods of treatment of cancer in recent years, is the subgroup of interventional radiology that deals only with cancer.

Diagnostic biopsies and current targeted treatment methods of many cancers such as kidney, lungs, pancreas, liver cancers and liver metastases may be performed through interventional oncology.

In the multidisciplinary tumor board consisted by specialist doctors from different branches,  targeted treatment protocols are set with a personalized treatment approach for the patients to be cured through interventional oncology.



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