Rethink Imaging

EP 44 • May 14, 2026

Killing Tumors Without Chemo: Sci-Fi Treatments Already in Hospitals

Featured Guest

Dr. Mina Makary, MD, FAHA, FSVM

Vascular & Interventional Radiologist; Director, IR APP Inpatient Service; Clinical Associate Professor of Radiology • The Ohio State University Wexner Medical Center

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Cancer care has three traditional pillars: chemotherapy, surgery, and radiation. Dr. Mina Makary works in the fourth. In part two of his conversation with Chris St. John, the Ohio State interventional radiologist describes treatments that kill tumors through a pinhole or, in the case of histotripsy, no incision at all. Focused ultrasound waves destroy the tumor by cavitation while the patient lies on the table, then they go home the same day. Dr. Makary performed one of the first three histotripsy cases in Ohio, and he walks through why the approach spares nearby structures, sidesteps the heat sink problem, and may even prime the immune system to attack untreated tumors.

The second half covers the embolization playbook: microscopic beads that starve tumors of blood supply, shrink uterine fibroids without a hysterectomy, and treat enlarged prostates without touching the urethra. Dr. Makary also shares the story behind his genicular artery embolization service line, which started in 2022 with a 90-year-old patient who wanted an alternative to a second knee replacement. She got up to two years of relief, and Ohio State is now a national site in the MOTION trial studying long-term outcomes. The episode closes on where AI fits into all of it, from patient selection to after-hours chatbots.

Host

Chris St. John

Host, Rethink Imaging • Imalogix

Featured Guest

Dr. Mina Makary, MD, FAHA, FSVM

Vascular & Interventional Radiologist; Director, IR APP Inpatient Service; Clinical Associate Professor of Radiology • The Ohio State University Wexner Medical Center

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Key Takeaways

Interventional oncology is now the fourth pillar of cancer care alongside medical, surgical, and radiation oncology. Radiation segmentectomy uses Y-90 beads delivered through tumor-feeding arteries to hit a liver segment with a surgical-strength dose, no incision required.
Histotripsy destroys tumors with focused ultrasound and no needle. Dr. Makary performed one of the first three cases in Ohio. The technique spares adjacent structures, avoids the heat sink effect that leaves residual tumor near blood vessels, and may prime the immune system to attack untreated tumors elsewhere.
Genicular artery embolization treats knee arthritis pain by blocking abnormal blood vessels feeding inflamed sensory nerves. Some patients get relief for up to 24 months, versus a few months for injections. His first patient, a 90-year-old woman treated in 2022, has still not needed her second knee replacement.
Uterine fibroid embolization shrinks fibroids while keeping the uterus, uses conscious sedation instead of general anesthesia, and can be done outpatient. Data now shows pregnancy is safe after the procedure, yet many patients only find the option by searching online.
Prostate artery embolization treats BPH through a tiny wrist or groin puncture rather than through the urethra, avoiding the stricture and erectile dysfunction risks that come with the surgical route.

Full Transcript

[00:00:00] Mina Makary: Another version of it that came out recently in recent years is called histotripsy, which I’ve been honored to offer one of the first three cases in Ohio. And this is a treatment where we use ultrasound waves to do the ablation without a needle even. So there’s no Band Aid even. Patient comes in. We put a device on their body. We target the tumor. We kill the tumor. They go home. So that’s the future.

[00:00:28] Chris St John: Welcome to Frame by Frame Rethink Imaging, a podcast by Imalogix. Here, we explore the intricate world of medical imaging, aiming to dissect the field and inspire both professionals and curious minds alike. I’m your host, Chris St. John. Welcome back to part two of our conversation with doctor Mina Makary, a dual board certified vascular and interventional radiologist at the Ohio State University Wexner Medical Center. He holds several leadership positions there and has introduced multiple cutting edge service lines. His work focuses on making radiology patient facing and expanding access to minimally invasive therapies. If you haven’t listened to part one of our episode, I highly suggest that you go back and listen to part one with doctor McCary where we covered the basics of interventional radiology and a bunch of other subject matter. So if you haven’t listened yet, feel free to go back. And if you don’t want to, that’s fine too. Part two of our conversation is where we really started to get into the specifics of the cutting edge work that doctor McCarrie is doing. And to some degree, it almost made me a little bit frustrated, not at doctor McCarrie at all, but at the gap between what is possible and what most patients even hear about or come across in their everyday life. We dive into cancer ablation where patients go home the same day with nothing but a Band Aid. We talk about fibroid treatments that don’t require a hysterectomy, knee pain relief that lasts for years. I kept thinking about the people I know who have gone through procedures to solve these problems, larger procedures, more dangerous procedures that didn’t have any other options. And I think that’s why I found this conversation with doctor Mankari just so engaging. He’s he’s a fascinating speaker, and he has a passion that runs through all of the work that he does. So please enjoy part two of our conversation on the cutting edge technology going on interventional radiology, and enjoy the show. Welcome back to our conversation with doctor McCary from Ohio State University. You know, last or a couple of weeks ago, we were talking about, you know, interventional radiology. We were having high level conversations about what they’re up to at Ohio State, how to practice good medicine, communication practices. But because you’re up to so much, you know, I wanna hear more about some of the cutting edge work that y’all are doing over there. So before we even get into the questions I have prepared, at the top of the episode last week, you touched on some of the cancer ablation work that you’re doing. And I believe you said something along the lines of walk out cancer free same day with nothing but a Band Aid or some some sort of phrasing close to that. I feel like that’s where we gotta start.

[00:03:15] Mina Makary: Oh, absolutely. Yeah. So interventional radiology is amazing, and it’s on what it offers to to, uh, patients cancer patients. And, traditionally, in cancer, you have three pillars of treatment. You have medical oncology, so these are the doctors that provide chemotherapy, immunotherapy nowadays, and other things. You have surgical oncology, these are the surgeons that cut out disease. You have radiation oncology, and these are the doctors that offer radiation. So medical, surgical, and radiation oncology are the three pillars of cancer traditionally. Now the newest pillar is interventional oncology. That is the fourth pillar of cancer care, and this is what interventional radiology offers to cancer patients. And those are usually two groups of treatments, either treatments that where we go into the blood vessels directly supplying the tumor and inject beats that have nothing on them or chemotherapy or radiation. And the beauty of that is that, basically, instead of getting a chemotherapy in your IV that goes into your entire system or circulation, you’re putting the treatment directly at the doorstep of the tumor inside the body. So all that treatment goes directly in the tumor. And then also you’re putting beads that stop the flow, so you’re cutting off the blood supply so the tumors die because they don’t get oxygen or nutrients or blood flow. And that can be chemo. It can also be radiation. And one of these forms is called y nine d radiation, and and it’s so effective in certain cases. It’s called a radiation segmentectomy. So segmentectomy is a surgery where we cut out cancer. Radiation segmentectomy is because we can select the vessels, supply the tumor, we can give such a high dose that we can actually do a segmentectomy without doing a segment without cutting the patient up. So those are the ones where we go into the blood vessels. What you’re referring to are a group of treatments we call ablation. Mhmm. Those are even more amazing in the sense that we put a needle in a patient, one or more, and we can freeze or heat up a tumor, and we can kill it in real time, and you can see it dying. And then remove it, and then put a Band Aid and send the patient home. No blood loss, minimal, nothing, no issues. And because you killed it in real time, they’re cancer free. And you don’t even have stitches. You don’t have you’re not cutting open. Nothing. So this is a very, very, very amazing thing that we offer patients. And, obviously, it’s for, like, select tumors. It can be in the kidney, in the lung, in the liver, in different organs, others other other organs also. But it it’s a huge thing because it’s very effective, and it’s minimally invasive. And another version of it that came out recently in recent years is called histotripsy, which I’ve been honored to offer the fur one of the first three cases in Ohio or in the region among the earlier cases in the world even with a colleague. And this is a treatment where we use ultrasound waves to do the ablation without a needle even. So there’s no there’s no Band Aid even. Patient comes in. We put a device on their body. We target the tumor. We kill the tumor. They go home. No Band Aid even. So, uh, that’s e that’s e that’s the future. There’s a lot of research that we’re doing on this and a lot of exciting work in development as well. So that’s really exciting. These are the great options that we have for our patients.

[00:06:46] Chris St John: You know, I’m I’m imagining all of these tiny little microscopic beads. You say sometimes they have, you know, chemo on them. Sometimes they’re just as is. I’m curious, like, are are are they all the same small little beads or particles? Do you know? Or do is it, like, where you have, like, you know, just a toolkit and they’re all a little bit different? And then what happens to them after the procedure, I guess, is my question.

[00:07:14] Mina Makary: Absolutely. That’s a fantastic question. So in the liver, the liver has dual blood supply and has arteries and it has a portal vein. And the normal liver gets supplied by the portal vein, and the tumors generally are supplied by the arteries. So the reason we can block the arteries, kill the tumors without killing the liver is because it has a dual blood supply. So when we use these particles that you mentioned, there’s different options. They come in different sizes. Mhmm. Depending on the cancer type, the science have shown different chemotherapies or different cancer sizes or, uh, particle sizes may be appropriate. And then sometimes we also quote them with radiation and deliver radiation this way. And in some cancers, the ones without anything on them is as effective, so we don’t have to give the chemo. That’s why there’s bland, which we call them, bland particles also. They’re made of plastic or plastic variants, so they’re permanent unless we want them that way because we wanna block the vessel supply in the tumor. Right. And we don’t want them to open up again and then, you know, the tumor to come back. So so they’re beads. They’re particles. They’re they’re small, oftentimes microscopic, and they come in different sizes. They have different treatments on them depending on the cancer type, and we can do that because of the safety of the of the other flow going to the normal parts of the liver.

[00:08:34] Chris St John: That is that is it’s crazy. Okay. Additionally, so you you touched that you, you know, you co performed one of the first few cases of the pronunciation, histotripsy?

[00:08:48] Mina Makary: Histotripsy. In in my state.

[00:08:50] Chris St John: Yes. In yes. Sorry. In in Ohio. Can you can you just tell me a little bit more more about that before I I I you know, I’ll have a follow-up.

[00:08:59] Mina Makary: Absolutely. So the whole premise of histotripsy is that it’s an ablation modality. So ablation is when we burn or freeze a tumor. Sometimes, traditionally

[00:09:10] Chris St John: Right. I’m I’m super familiar with, like, a cardiac ablation. Right?

[00:09:14] Mina Makary: Absolutely. So cardiac ablation burns the electrical pathways, the normal electrical pathways. So patient’s heart speeds through the proper electrical pathways. This is more invasive more destructive to the two the tissue or the tumor. And, traditionally, people use radio frequency energy, and then microwave came on, which is heat modality, and then cryoablation, which is use creating ice balls to freeze the tumor. And all these can destroy the tissue and kill the tumor. Now his atripsy uses ultrasound energy, and it’s deposited through the skin into the tumor. And it doesn’t heat the tissue. It kills the tumor by something called cavitation or mechanical destruction. So it disrupts the tissue. And there are many benefits. Some of them are established. Some of them are being researched, but it can spare normal structures around the the tumor, which is great. So if you have a tumor next to something, you don’t want it to get damaged, you wanna kill the cancer, but not the normal structures. It can prime the immune system. So the immune system can be primed through this treatment, so it can actually start attacking other tumors that may have not been treated even. It can also not succumb to limitations of traditional treatments like heat sink. So if you have a tumor next to a blood vessel and you try to heat it up, that side of the tumor next to the blood vessel might not heat up as much, and you might end up with a residual tumor or residual disease because of the limitation. It’s like water cooling off a faucet cooling off a hot, you know, bowl or something. Yeah. So so this heat sink effect doesn’t happen with this treatment. So lots of technical benefits. There’s also pros and cons depending on the size and location. It may or may not be effective. You know, there’s less science on it for certain tumors than others. So there there is a lot of science to be learned, but that’s one of the things that I love about interventional radiology is that we’re always coming up with a new best thing, and there’s always new technologies that are coming on that can improve patient outcomes.

[00:11:19] Chris St John: Right. I mean, absolutely. I mean, I know you’re also you mean, you’re developing nonsurgical options for fibroids, for prostate enlargement, for liver cancer, for other conditions. Right? Like, it it feels like the the limit does not exist to some degree.

[00:11:34] Mina Makary: Absolutely. And even pain intervention. So one of the most exciting treatments to me nowadays is something called genicular artery embolization. So something as simple as knee arthritis. So knee arthritis, people used to think it’s wear and tear Right. And that causes the pain. And more more recent science showed that it’s basically in there’s an inflammatory component. The first few steps are inflammatory. The inflammation increases the blood abnormal blood vessels go into the nerves, and the sensor nerves cause the pain, and then people have pain. And knee pain is very common. Above age sixties, almost fifty percent of folks have it. And it can be limiting if you can’t walk, you can’t take care of yourself, you can take care of your family, you can you can do your daily activities. You can shower. You can eat. You can’t work. You can do anything. And as you get older, if you are immobile and you’re in bed, you can get sores and you can get clots, and you can it can really affect your whole life. So, traditionally, knee arthritis, the treatment is you take pain pills, which don’t last for a long time and have other side effects. Then you can get knee injections, which last a few months. But then after that, the next best thing is a knee replacement surgery, which is a big surgery. You have to be under anesthesia. You have to be out. Anesthesia. You have to be out. You have to be in rehab for a few months or a year after to gain your strength. If you’re older, you may not be even a candidate or certain types of issues. So we, in our specialty, developed a new treatment called genicular artery embolization. It’s been there for a a while, but now we have more science specifically for pain. It used to be used for bleeding in the knee or other issues. And we can go in. We can block using similar, you know, beads, and there’s different or other medicines to block the abnormal blood vessels while keeping the normal blood vessels open, and patients can have pain improvement. And the beauty about this, unlike the other treatments that, you know, may be there for a few months, this in some patients, you can get relief up to twenty four months. So my first patient was a 90 year old lady who had knee replacement in one leg and had complications, and she was debilitated and had issues. And she came to me. She’s like, hey. You her her grandson actually came to me and introduced me to her. They know that I’m innovative, and I do things outside the box. And this is was in 2022. So this was my first case. I started the service line back then, and now we’ve we have a huge collaboration with Ortho Orthopedics and Sports Medicine and others. But at that time, I offered her treatment, and she’s done great. And she hadn’t had she to this date, she hasn’t had her second knee replacement, and she had great relief, and she was so happy. She’s actually a very funny lady. She would call me, like, every six months. She’s like, if I need this, can I get it again? I was like, is your pain back? No. But I’m just asking because this worked, and I’m not sure. So she she, uh, she did great, and that what actually inspired me to to to introduce this. Because this is technically complex. The anatomy is tricky, and you have to know what you’re doing. But it was something that really inspired me to to push the envelope and give patients options.

[00:14:44] Chris St John: And so and you’ve you’ve been doing this procedure more since then. Yeah?

[00:14:48] Mina Makary: Oh, absolutely. I’ve been doing it. I’ve created an educational website. I’ve done some research on the topic. I’ve worked with my colleagues in other departments to to give lectures and to educate. And, you know, obviously, I’ve helped my colleagues participate in this, so it’s a team effort. It’s not just me. And I also, one of the things I like anytime I build something new is I like to contribute to the science. So I enrolled our group in a national trial called the motion trial to understand the long term effects of of of that treatment, and we’re one of the national sites. The treatment is standard of care, so we can do it even without the patient being in a research trial. But if they wanna advance the science by using their data, we can also so and I’m in discussion with other trials as well. But it’s been a great journey, and I really enjoy, you know, building these service lines and giving, you know, patients cutting edge care. And and so what excites me about IR?

[00:15:46] Chris St John: Absolutely. And so once again, the term was genicular artery embolization. Right? Correct. Okay. So if if if folks wanted to actually go to your website, learn more about this, where where would they be able to find all that information?

[00:16:01] Mina Makary: So if they type my name and geniculate heart embolization so there’s an Ohio State website that that had that is basically an article that I wrote on the topic, and it has the information of who’s a candidate, how it works, who they help. It has a diagram. It also has a scheduling number if they wanna come and see us. Um, I also have an online educational video about the topic to, you know, raise awareness, and I also have several publications that they can find online. So if they if they type my name and the name of the procedure, they’ll find it. Just very briefly, genicular is the name of the vessel that we one or more vessels that we treat. Artery, obviously, is the artery. And then embolization means to block up that blood vessel or that abnormal blood vessel. So for them, they would think about it. We’re blocking the abnormal blood vessels that are contributing to the pain.

[00:16:55] Chris St John: Yeah. Honestly, I’m I feel like I I just keep wanting to return to the fibroid conversation. I don’t know why it’s sticking out to me, but I would I would just love to get a little bit more I I know a lot of of a lot of folks, primarily women who have dealt with, you know, serious fibroid issues, and I’m I’m curious as to, you know, most of them ended up having, you know, surgery of some sort, hysterectomy or, you know, various procedures. But I’m curious what y’all are up to.

[00:17:23] Mina Makary: Absolutely. So fibroids are very, very common in women. And they’re not cancer, but they can cause a lot of symptoms. So they can cause bleeding symptoms where where women or patients have increased bleeding in their in their menstrual cycle. They can have spotting. A lot of times, they have to change their pads multiple times a day. It’s very disruptive. Some of them get anemic or their blood levels or hemoglobin goes down, so they are tired and fatigued and pale and sick.

[00:17:49] Chris St John: That was that was happening to many many close friends of mine a few years ago. It it seemed like everybody was just continued to run into these issues. Yeah.

[00:17:58] Mina Makary: Absolutely. And it it’s a very, very common issue. And and some patients, you know, some some patients might not know that they have this issue. They oh, I’ve always thought that my period is, you know, ten days or it’s always heavy, and I thought that’s what’s normal. And, obviously, some, it can get really bad, and and they seek more attention. But those are the type of symptoms. They’re co bleeding symptoms. They also can cause bulk symptoms. As As they get grow bigger, they can compress other structures. So they can get they feel pelvic pressure, pain, cramps because of and, you know, the the fibers grow so big in their pelvis, the bladder doesn’t fill as much. So they end up with urinary frequency. They go to the bathroom a lot. So as you can imagine, if you’re trying to work or or traveling or this or that, it’s just a huge quality of life issue. And the issue is that, you know, if you have mild symptoms, they can get birth control over medicines that can affect their hormones. And even those have side effects, some patients can gain weight. Some of them can have depression. Some of them can have clots in their legs or strokes. So it’s not even as benign as people think, but some patients like that or some people don’t. Or some people wanna get pregnant, so they, you know, they won’t don’t wanna take those. But once you get moderate to severe symptoms, you need a treatment. And options are, generally speaking, surgery, meaning hysterectomy where they remove the uterus, bigger surgery, there’s high risk of bleeding, they remove the uterus so they can get pregnant again. It has to be done under general anesthesia, so they’ll be out and asleep, have a machine breathe for them, obviously, and their recovery is longer in the hospital and outside. But it’s the right option for some patients, and it’s quicker. They can get immediate results. There’s a lesser version of it called myomectomy where they remove select fibroids, but oftentimes requires a skillful surgeon, and it depends on and it still requires general anesthesia, still longer recovery. Um, but they can select some of the fibroids, and they can’t they can’t treat all of them with that approach. So that’s one option. It’s, again, it’s it’s good for some patients, not good for others, pros and cons. The interventional minimally invasive option is called uterine fibroid embolization. And in that approach, we go into the blood vessels that supply fibroids. We block them. We shrink the fibroids. It’s a natural process.

[00:20:09] Chris St John: Mhmm.

[00:20:10] Mina Makary: And the beauty of that is that you can keep your they can keep their uterus. They don’t have to have scar. They don’t have to be under anesthesia as a conscious sedation, so they’re sleepy but comfortable. We can talk. They can go home quickly. And sometimes done outpatient same day, and they can recover quickly. Now the pros and cons is that I think of uterine fibroid embolization as more natural. We shrink them. It took years for them to grow. It might take a couple months for them to you know, a few months and even longer to to to get the full effect, so they shrink over time. If you do a hysterectomy, you can get immediate, you know, removal of the fibroids, but the recovery in terms of pain and bleeding and other issues may be longer. The fibroid the DIAR treatment or the embolization, your urine sparing, which is great. And we’ve done we have now signs showing that you can get pregnant after this procedure, so it should not affect her. At the beginning, we did not know

[00:21:07] Chris St John: if

[00:21:07] Mina Makary: it would affect it or not, but now we have data showing that it is safe to get it if you wanna get pregnant, so it doesn’t limit their options. And at the end of the day, you know, if we do anything and this is a general principle in medicine, at least in my mind. If a patient is a candidate, I think it’s always best to try something minimally invasive. If it worked, you’re happy. You’re done. You haven’t lost anything. If it didn’t work or is not you’re not as happy, you can always do the the more minute the more invasive option. But if you start with a hysterectomy or a surgery or something when you are a candidate to more to less invasive options, then you are basically let you know, you may be taking risks that you don’t need to. But, again, I don’t think, you know, I think it’s a great option. I think a lot of patients don’t get access to it. Many of them, you know, tell me that they found it online or they asked their doctor he didn’t know or he said it might not work, and then it did. And then they went back and told him it did or this and that. So lots of awareness that needs to be done. But that’s basically how we do it.

[00:22:05] Chris St John: Yeah. So would I be correct in making an assumption that your work with prostate enlargement as well is also an embolization procedure?

[00:22:17] Mina Makary: Absolutely. So similar to the other options that we discussed, BPH or benign prostatic hyperplasia is a condition in in older men where the prostate gets bigger over time. If we all live long enough, you know, because of the testosterone and other hormones, the prostate would get bigger. So, you know, if you may or may not, but if you ever you know? Who doesn’t have a grandpa who wakes up in a Malone? Absolutely. Yeah. So that’s a very common issue. And there are different treatment options for this issue. They can be surgical or interventional. And the goal of treatment is to help improve those symptoms. So patients may have frequent urination. They may do have to wake up at night. It’s called necturia. Or they may have weak stream or dribbling or incomplete emptying of their bladder. And it becomes a big issue because in older men, they might need catheters and might can get infections, and their quality of life is terrible. I had a guy the other day tell me he, you know, he can’t spend time with his grandkids or can’t travel or can’t do this or he’s always at home because he has to pee every, you know, every hour. He has to go or find a bathroom. So it can be very, very disruptive, and it can have downstream effects. And the surgical options are more invasive. They usually involve, you know, cutting the the prostate out or cutting part of the prostate or lasers or different treatments that are going through the urethra or the private organ directly into the prostate. So that’s again very invasive, and patients may have strictures after, may have severe pain. They may have another thing that that patients that these procedures, some of them are at risk for is erectile dysfunction can happen after, which is a huge thing for for patients. The other option is embolization. We don’t go through the private area. We go through into our blood vessels to the wrist or the groin area, but not through, you know, the private area and make tiny incision, no stitches, nothing at the end. We go in with a small catheter and find the vessels just like with the fibroids or other treatments we do. We find the abnormal blood vessels. We block them. The prostate shrinks over time, and then patients have improved outcomes.

[00:24:28] Chris St John: Beautiful. I mean, the so I mean, the the you know, a a lot of what you’re working on are are, you know, similar approaches to solve different problems, which is I mean, it’s all just incredible. But I’m curious, like, what are you obviously, you’re excited about all of this, but what are you most excited about in terms of the future of these procedures and cancer care in IR and being an early adopter of of these practices?

[00:24:53] Mina Makary: The future is bright. And to be honest with you, I am excited about the most simple procedure we do, a five minute procedure as as I am on a ten hour procedure, that spark or joy that I’ve had since I was a medical student and a resident and a physician at the end has never went away. I think the elegance, the technique, and the improved outcomes that we can offer patients and and just see him after and say, hey. You know, we took care of your bleeding situation. We took care of your issue. And and and seeing that the impact just really inspires me to work harder and to push the envelope. But in terms of innovations, I think every single aspect of IR has something big going on. And to me, cancer care is the the the crown jewel. And, you know, we talked about histotripsy is a great innovation in this field where we can not only ablate tumors, not minimally invasively, but actually noninvasively without, you know, an invasive approach. But, also, even in the y ninety or the radiation or the other chemo you know, the TACE or the the y ninety treatments that we offer with the beads with the chemo or radiation. There’s a lot of work on immunotherapy with these treatments, combination therapies or solo therapies. And that’s gonna be really, really impactful because we can improve our outcomes and cure more cancers and give patients more time to live. In the pain arena, genicular artery embolization has now expanded beyond the knee. So the the higher level concept is called TAME or transarterial embolization. So people are, you know, embolizing or blocking the the ankle for plantar fasciitis or the shoulder or the elbow. And there’s more data coming up, and this is exciting. Yeah. Yeah. Exactly. So so and the it’s now has expanded in so many amazing ways, and that and that gives me hope because pain is a huge issue. And if we can relieve people’s pain, I think this is it’s gonna be amazing. And there’s even cryoablation where we freeze nerves and can treat pains that way and blocks and other things that we didn’t really discuss, but there’s a lot of innovation in that field. In venous intervention, it is very exciting because we have newer devices that are more capable with less blood loss and, you know, less hospital stay and better outcomes. But, also, we have more data or more science showing, you know, especially in the lung lung and lower extremity that we can which patients we can help more. And I think this would really define the role of IR in that disease process and have significant impact. So those are the three areas that excite me the most, but I the way I look at my specialty, every single area, you know, I see great progress. And another thing that affects all of it is actually artificial intelligence

[00:27:44] Chris St John: Of course.

[00:27:44] Mina Makary: AI. And that’s a whole different world that we haven’t discussed as much here today, but that’s gonna help us, you know, deliver better treatments, pick better options, figure out which patients are responders and which ones are not before we even do a treatment, and help us become more capable. And not only during the procedure, but also through every phase of the patient’s care. So AI can help us with, you know, you know, scheduling. It can help us make sure patients are lost for follow-up. It can help us create patient educational materials that are easy to read or in different language if the patient is in English or create AI chatbots for, you know, after hours if somebody calls at two in the morning and there’s no specialist available. And is this pain normal? Is this not? I had this procedure for basic questions. So if you think about it, AI is gonna touch every single aspect of interventional radiology and in medicine in general. And I’m I’m part of the group that’s thinking that it will be for the positive, and we just have to leverage it and use it to to make our job better and to make us more effective for our patients.

[00:28:48] Chris St John: Yeah. Absolutely. And, also, how about us doing an hour and a half long ish recording talking about cutting edge medicine where we don’t touch on AI until the very end? I just have to say, that’s pretty impressive.

[00:29:03] Mina Makary: Well, either IR is just, uh, I mean, there’s just a lot to to to cover. Yeah.

[00:29:09] Chris St John: Absolutely.

[00:29:10] Mina Makary: But I’m glad we we the two approach is great. You know? You you ended up with a bang on the You have the innovations. So this is the innovations episode, and the other one was the the overall episode. Yeah.

[00:29:20] Chris St John: Yeah. I mean, I I mean, it’s 11:01. So let me just say, doctor MacKerry, thank you so much for joining us today on Rethink Imaging. It has been an utter pleasure to talk with you, and I hope to stay in touch and talk with you again sometime.

[00:29:35] Mina Makary: Absolutely. Thank you so much. I really enjoyed our conversation, and this was really insightful. And we touched on many amazing topics. I hope our audience can also appreciate appreciate this, and I look forward to, uh, future collaborations with you.

[00:29:49] Chris St John: Absolutely. I know they will. Thank you so much.

[00:29:51] Mina Makary: Thank you.

[00:29:53] Chris St John: Frame by frame, Rethink Imaging is brought to you by Imalogix. Here, you’ll find engaging interviews with thought leaders, experts, and patients sharing stories that showcase the transformative power of medical imaging. To discover how or wherever you listen. And from all of us here at

Questions from This Episode

What is histotripsy and how is it different from other tumor ablation?
Histotripsy kills tumors with focused ultrasound waves delivered through the skin, so there is no needle and no incision at all. Instead of burning or freezing tissue like radiofrequency, microwave, or cryoablation, it destroys the tumor mechanically through cavitation. That means it can spare normal structures next to the tumor and avoids the heat sink problem, where a nearby blood vessel cools the treatment zone and leaves residual disease.
Can women still get pregnant after uterine fibroid embolization?
Yes. Dr. Makary says the data now shows pregnancy is safe after the procedure, which was an open question when it was first introduced. Because the treatment shrinks fibroids by blocking their blood supply rather than removing the uterus, patients keep their fertility options, avoid general anesthesia, and often go home the same day.
How long does genicular artery embolization relieve knee arthritis pain?
Some patients get relief for up to 24 months, compared with a few months from steroid injections and even shorter windows from pain medication. The procedure blocks abnormal blood vessels that feed inflamed sensory nerves in the knee while leaving normal vessels open. It is standard of care, and Ohio State is a national site in the MOTION trial tracking long-term outcomes.