ECR 2026 devoted this session to the expanding scope of interventional imaging, showing how innovation is changing practice across breast procedures, nuclear medicine, cardiovascular intervention and radiation therapy. Although the technologies discussed were varied, the presentations converged on a shared goal: using better guidance, more precise targeting and stronger multidisciplinary collaboration to improve outcomes and patient experience. The tone was practical throughout, with each speaker focusing not only on what is new, but also on how these developments can be integrated safely and effectively into clinical care.
Advances in Guidance and Targeting
Noelle Frances Clerkin began with interventional mammography and the close collaboration required between radiographers and radiologists. She described a field in which image-guided breast interventions can be performed under ultrasound, MRI and X-ray guidance, including stereotaxis, digital breast tomosynthesis and contrast-enhanced mammography. For Clerkin, technical progress is closely tied to teamwork and patient benefit. As she put it, “collaborative teamworking is essential”.
Her presentation highlighted how newer modalities can improve lesion visualisation and targeting. Digital breast tomosynthesis helps reduce the effect of tissue overlap and can make subtle abnormalities easier to detect. Contrast-enhanced mammography can help clarify enhancing foci and support decisions about which lesions should be sampled. These developments also connect to improvements in biopsy and localisation methods, with the overall aim of increasing procedural accuracy while also improving safety and comfort for patients. Clerkin’s message was clear: teams should “embrace technology” and use tools such as DBT and CEM “to better select and target lesions appropriately”.
Jelena Perić then shifted the focus to nuclear medicine-guided interventions. She presented nuclear medicine as a discipline that is no longer limited to diagnosis alone. “Imaging today no longer serves only for observation,” she said, because it now also supports “navigation, patient selection and therapy delivery”. Her talk centred on PET-guided biopsy, focal therapy delivery techniques and radio-guided surgery.
PET-guided biopsy was presented as particularly valuable when conventional imaging does not clearly identify the best site for tissue sampling. By locating the most metabolically active part of a lesion, PET can support more representative biopsy targeting and help reduce the risk of false negative results. Perić also highlighted the role of nuclear medicine in therapy delivery and in radio-guided surgical approaches, showing how it now contributes across the oncology pathway rather than at a single diagnostic stage. Her presentation showed how intervention is becoming increasingly informed by functional as well as anatomical information.
Innovation in Cardiovascular Procedures
Irene Nieri focused on cardiovascular interventional procedures and described innovation in practical, not abstract, terms. “New doesn’t necessarily mean something that has never seen before,” she noted, but rather something improved, safer or more effective. Her presentation reviewed developments including fusion imaging, AI-enabled software, robotic assistance and emerging device technologies.
Fusion imaging was one of the central examples. By combining modalities and superimposing 3D virtual images on fluoroscopy in real time, these systems can support procedures in both vascular interventional radiology and interventional cardiology. The aim is not novelty for its own sake, but better procedural navigation and accuracy.
Nieri also explored AI-based tools in the cath lab. The dynamic coronary roadmap can provide a motion-compensated real-time view of the coronary arteries, helping reduce contrast use and radiation exposure by lowering the number of angiography runs required. Other software tools can automatically identify vessels and assess stenosis, lumen diameter and lesion length. She also referred to AI-supported intravascular ultrasound and optical coherence tomography applications, where automatic segmentation and plaque characterisation can support more tailored decision-making. In her words, this is “a moment of revolution and innovation”.
At the same time, she was careful not to present these advances uncritically. Robotic assistance may reduce operator radiation exposure and improve ergonomics, but it also has limitations, including longer procedural times and reduced ability to adapt to anatomical variability and patient-specific complexity. Looking ahead, she mentioned bioresorbable scaffolds, drug-coated balloons, transcatheter valve replacement, 4D-printed implants and digital twins. Even in this forward-looking perspective, however, she stressed that training, research and collaboration remain “mandatory”, while privacy, security and regulation continue to demand attention.
Precision and Teamwork in Radiation Therapy
Patrizia Cornacchione concluded the main body of the session with interventional techniques in radiation therapy, with particular attention to brachytherapy. She described a field that has moved progressively from what could simply be seen, through 2D and 3D image guidance, towards more advanced approaches involving organ-motion management, target biology and a more personalised focus on patient needs.
In brachytherapy, she outlined the evolution from linear source delivery to intensity-modulated and adaptive techniques. These advances make it possible to cover the target more effectively while better sparing organs at risk. Imaging support now extends beyond MRI and CT to include ultrasound as well, further strengthening treatment precision.
Yet Cornacchione’s strongest emphasis was on the human side of innovation. “The multidisciplinary approach is the very important key,” she said, stressing that success depends on multiple professionals working together. In her examples, the workflow may involve anaesthesiologists, radiation oncologists, nurses, radiation therapists and therapeutic radiographers sharing the same space and contributing different forms of expertise. That requires not only technical competence, but also a clear understanding of “the different skills of the different professional”.
She also underlined that brachytherapy is “an invasive treatment for the patient”, which makes communication especially important. Preparation, coordination and attention to the patient experience are therefore not secondary concerns, but part of the treatment itself. Her presentation broadened the session’s overall discussion by showing that precision in intervention is inseparable from teamwork and patient-centred care.
Conclusion
Across all four presentations, technological progress was presented as meaningful only when it supports better care. In interventional mammography, advances in imaging and biopsy techniques promise more accurate targeting and greater comfort. In nuclear medicine, PET-guided biopsy and radio-guided approaches extend imaging into intervention and therapy delivery. In cardiovascular procedures, fusion imaging, AI tools and robotics are opening new possibilities while also raising practical and regulatory questions. In radiation therapy, increasingly refined brachytherapy techniques are improving precision, but only within a strong multidisciplinary framework. Taken together, the session showed that the new frontiers of interventional imaging lie not only in smarter tools, but in the ability to use them collaboratively, safely and with clear benefit for patients.
Source & Image Credit: ECR 2026
