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over the last 25 years. Technological refinements, increased precision of devices, evolving subspecialty fellowships and improved treatment techniques give radiologists an expanded comfort zone to take on complex procedures that deliver increased patient benefi ts. Drs. Inampudi and Tubman are members of Consulting Radiologists Ltd. (CRL), a physician-owned practice of 75 board-certified radiologists that has been serving the upper Midwest for more than 80 years. CRL provides on-site services at more than 37 hospitals and clinics and teleradiology services to more than 100 radiology departments in fi ve states. The practice delivers a range of radiology services to the health care community, representing such imaging subspecialties as breast, body, diagnostic, interventional, neuroradiology, interven- tional neuroradiology, musculoskeletal, nuclear medicine and pediatrics. CRL uses an array of imaging technologies and devices designed to treat patients using less invasive procedures that offer lower risk, reduced pain and shorter recovery time than open surgery. CRL’s group of interventional neurora- diologists — and the accessibility of their expertise — will be expanded this sum- mer with the addition of Josser Delgado Almandoz, M.D. After completing his fellowship in St. Louis, he will join CRL and share a rotation with Dr. Tubman and Benjamin Crandall, D.O., enabling CRL to provide timely treatment for stroke patients. “Our liver embolization and stroke pro- grams are two examples of sophisticated research and therapy advances that we offer to the Twin Cities and surrounding states,” says Neeraj Chepuri, M.D., diagnostic neuroradiologist and President of CRL. Dr. Inampudi is a member of CRL’s Interventional Radiology Group and handles liver tumors with new treat- ments that can be delivered directly to the tumor without significant side effects or damage to nearby normal tissue. Radioembolization is a radiation therapy used to treat patients with either primary or metastatic liver cancer. Because radiation applied from the outside kills the normal liver as well as the liver tumor, radiation therapy has not had a major role in treating liver tumors. Radioembolization, however, uses Atrium 90, which emits radiation only 1 to 3 millimeters from the point of deposit. “We selectively infuse the tumor with this radiation through beads placed in the tumor that emit tumor-killing radiation while doing very little damage to the surrounding liver tissue,” explains Dr. Inampudi. “Our goal is to wipe out the tumor without signifi cantly impact- ing the normal liver.” CRL’s radioembolization program at Abbott Northwestern Hospital is one of only two centers in the state of Minnesota offering the procedure. Over the last four years, the CRL program has treated 250 patients with radioemboliza- tion of the liver, ranking it among the busiest practices in the country. Dr. Inampudi and the interventional group treat tumors that respond better to chemotherapy with a procedure called chemoembolization. Doxorubicin-coated LC beads, 100 to 300 microns in size, are navigated through the blood supply and selectively deposited in the circulation within the tumor. The beads stay in place, delivering the chemotherapy with extremely good results. These treatments expand options for handling a number of liver cancers, including patients with hepatocellular carcinoma. “This cancer evolves over years in patients with hepatitis B and hepatitis C; we are currently seeing a peak in these tumors,” explains Dr. Inampudi. “If detected early enough and in a good stage, liver transplantation is still the best solution, but there are only so many livers available. We have a University of Minnesota transplant surgeon at our Monday morning coordinating meetings to evaluate and prioritize transplant candidates. When transplant is not an option, we use our meetings to review the evidence and consult with liver surgeons about whether tumor dissection is the best option for the Drs. Inampudi and Tubman consulting on a case in the interventional suite patient. If the answer is ‘no’, we consider whether we can kill the tumor using chemoembolization, radioembolization, microwave ablation or cryoablation. “When someone has cancer in the liver,” he continues, “it’s not enough to have one specialist, in isolation, advising the patient. We work with Abbott Northwestern and the Virginia Piper Cancer Institute to consider the best options for the patient across a multidisciplinary perspective.” “I will tell you what is different about CRL’s partnership at Abbott,” states Dr. Inampudi. “Many practices are well-trained. Our real distinction is our collaborative team approach. We seek to be a community resource. Every specialist here realizes he or she cannot care for the patient optimally without the collaboration of colleagues, and in our weekly conferences, this is exactly what we do. Individually, we see the patient in the clinic. Then, on Mondays, we gather to collaborate about the patient’s care options. We discuss and come up with a consensus.” One of Dr. Inampudi’s colleagues, Timothy Sullivan, M.D., Chairman of Vascular/Endovascular Surgery at the Minneapolis Heart Institute, agrees. “I have practiced in a number of high-profile institutions with well- deserved reputations in the care of MDNEWS.COM  MD NEWS Twin Cities | 9 PHOTOS © DAVID GINSBERG

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