Each year, CIRSE highlights superlative work with Best Scientific Paper Award and the Magna Cum Laude Poster Award. This year’s winners spoke with us to share their motivations and background behind their outstanding contributions to CIRSE 2024.
Dr. Martha-Gracia Knuttinen (Scottsdale, AZ/US)
CIRSE: What motivated the research behind your paper?
Knuttinen: Chronic pelvic pain in women is a chronic disabling condition, and many women suffer in silence with a significant burden on their quality of life. It can sometimes be easier for the medical community to label these women as histrionic and dismiss some of their symptoms rather than working on making a diagnosis. Pelvic venous disorders (PeVD) are often underdiagnosed, misdiagnosed, and undertreated. Furthering research in this area can lead to a better understanding of the complexity of this disease and its pathophysiology. In the last several years, literature and evidence have shown the importance of pelvic venous reflux and/or compression in the workup and management of female pelvic pain. In the past two years, there have been only a few retrospective reviews that have shown possible connections between PeVD and other disease processes, such as IBS, migraines, orthostatic intolerance, dysuria, vulvodynia and dyspareunia.
We sought to prospectively investigate pelvic and non-pelvic symptom improvement in women treated for PeVD using standardized and qualified QOL surveys to follow pelvic pain patients. Our data strongly supports symptom improvement at 3 months, sustained to a year across all QOL surveys. One of the largest impediments to care in patients with iliac vein compression is the belief that this causes only deep vein thrombosis (DVT) or severe left lower extremity pain or swelling. We hope that our research sheds light on the positive impact that effective interventional treatment strategies can have on many patients’ quality of life who suffer from PeVD and opens the door for further research on the impact and causality of vascular disease in POTS, IC, IBS, migraine headaches, chronic fatigue, and a myriad of systemic symptoms.
CIRSE: Why did you decided to submit your paper to CIRSE 2024?
Knuttinen: When I think of the CIRSE Annual Congress, the words “innovation and forward thinking across global boundaries” come to mind. Presenting this work at CIRSE 2024 allowed us the opportunity to seek collaboration and prompt thoughtful discussions to advance how we as interventional radiologists are treating PeVD. We have come a long way from just gonadal vein embolization techniques for PeVD. It was exciting to see the interest from many of our international colleagues in furthering the research in this arena.
CIRSE: You were chosen to receive this year’s Best Scientific Paper award – what do you feel made your work stand out?
Knuttinen: Much of the prior work on PeVD has been retrospective case studies. My colleagues and I sought to look directly at symptom improvement in a prospective multi-centre trial in women treated for PeVD. We also challenged the field by investigating the potential for non-pelvic symptom improvement, such as migraines, GI and GU symptoms, and orthostatic intolerance. By performing a multi-centre prospective trial, the data lends itself to more powerful statistical analysis compared to a single-centre experience.
It was many years ago that Dr. Spencer, Dr. Smith, and I conceived of and designed this study at an SIR meeting, and we procured funding for our study. I would like to thank all of my colleagues involved in this multi-site prospective trial for their efforts. Our trial was set back during the COVID pandemic, which affected non-urgent treatments across the US, but ultimately, we were able to continue forward progress. It certainly took perseverance to continuously work together to complete a cohesive data set. I would also like to thank CIRSE and the Scientific Programme Committee for the opportunity to share our results on a global scale. Advancing research in PeVD is exciting and bold, and this is only the beginning.
Dr. Shinichi Hori (Izumisano/JP)
Transarterial treatment of locally advanced breast cancer in de novo setting
What was the motivation behind your research?
Hori: I have been involved in the transarterial treatment of HCC (hepatocellular carcinoma) for a long time. During this period, I have also been involved in the development of spherical embolic materials. Believing that transarterial chemoembolization (TACE) could be applied to tumours other than liver tumours, I started treating breast cancer around 2006. With the advancements in imaging diagnostics, catheter techniques, and changes in medications, treatment outcomes have been improving.
Many patients with untreated, locally advanced breast cancer visit our hospital, and many of them cannot undergo other treatment methods. We actively treat these patients, believing that it is possible to improve their symptoms and improve their prognosis. By performing this treatment, we have observed many patients whose symptoms have disappeared and who have no problems in their daily lives, confirming that this treatment is a meaningful method.
From 2016 to 2023, we were able to treat 31 patients, and by analysing their survival rates, we believe we can provide evidence that this treatment method is superior. There are countless patients worldwide who have experienced local recurrence after standard breast cancer treatment or who have locally advanced breast cancer due to being unable to receive standard treatment for various reasons. It is important to show that there is a treatment path for these patients. I wanted to present this treatment at a meeting of interventional radiologists to advocate for its usefulness.
CIRSE: Why did you choose to submit this poster to CIRSE 2024?
Hori: CIRSE is the largest and most historic conference in interventional radiology, and I thought it would be the best opportunity to let interventional radiologists around the world know about this method. Creating poster materials was not a significant burden, so I would like to encourage many researchers to submit their presentations.
CIRSE: Your poster was awarded magna cum laude – what do you think made it stand out from the rest?
Hori: I believe my research had a solid clinical necessity. I think the reason for the award was that I was able to analyse the side effects that occurred from the treatment and to demonstrate the survival rates. However, I found it challenging to fully convey the specific methods of this treatment. I aim to publish it as a formal paper as soon as possible.
Since medical systems vary by country, I understand that it may be difficult to immediately adopt our breast cancer treatment methods. However, breast cancer is a common cancer, and the number of patients is increasing worldwide. I am considering other ways to encourage interventional radiologists to actively engage in this treatment and intend to submit work to CIRSE 2025.
Congratulations to Dr. Knuttinen, Dr. Hori, and to everyone who submitted outstanding work to CIRSE 2024.
Dreaming of winning one of next year’s top awards? It’s not too early to start preparing – abstract submission for CIRSE 2025 will open in January!
