Pillar 03
The common-procedure foundation of non-vascular IR — biopsy, drainage and access work that registrars meet earliest and most often — through to hepatobiliary, urinary and enteric intervention and interventional-oncology principles.
Clinical topics in this pillar are educational categories only and require consultant review before publication. WIRS authors no procedural instruction.
Where to start — the shared baseline for students, interns and junior MOs.
Biopsy
An orientation to image-guided biopsy as a clinical concept — how a target is selected and planned for, and the role biopsy plays in diagnosis, at a conceptual level.
Why it matters. Biopsy is often the first non-vascular activity a registrar encounters and underpins much of diagnostic and oncological care.
Learning objectives
Discuss with WIRS
Case-conference slot pairing a recent biopsy referral with its multidisciplinary outcome.
Related topics
Drainage
An orientation to collection drainage — the categories of fluid collections drained under image guidance and the pigtail-catheter concept, as clinical categories rather than procedural steps.
Why it matters. Drainage is high-volume, often urgent, and connects IR to surgery, gastroenterology and critical care on almost every on-call shift.
Learning objectives
Discuss with WIRS
Journal club on catheter-versus-surgery outcomes for common collection types.
Related topics
Working knowledge expected across the FC Rad Diag(SA) registrar years.
Pleural drainage
Pleural effusion and pneumothorax drainage as a clinical concept — indications, the idea of a pleural catheter, and how this work sits alongside respiratory and surgical teams.
Why it matters. Pleural disease is common and frequently referred to IR; understanding the pathway supports timely, well-coordinated care.
Learning objectives
Urinary tract
Percutaneous nephrostomy as a clinical concept — why an obstructed or infected collecting system needs urgent decompression, and how this sits within a urology-radiology pathway.
Why it matters. Obstructive uropathy and pyonephrosis are common emergency referrals; recognising urgency and the reasoning behind nephrostomy is core registrar knowledge.
Learning objectives
Discuss with WIRS
Lecture on recognising obstructive-uropathy urgency on cross-sectional imaging.
Related topics
Urinary tract
An overview of urinary diversion and ureteric intervention categories — antegrade ureteric stenting and related concepts — as an extension of upper-tract decompression.
Why it matters. These interventions recur in oncology and reconstructive urology pathways, and registrars benefit from seeing them as a connected family with nephrostomy.
Learning objectives
Related topics
Hepatobiliary
Percutaneous transhepatic biliary drainage as a clinical concept — why an obstructed biliary system is decompressed, and the multidisciplinary hepatobiliary pathway it sits within.
Why it matters. Biliary obstruction (benign and malignant) is a frequent hepatobiliary-MDT referral, and PTBD is a common point of contact between IR, surgery and oncology.
Learning objectives
Discuss with WIRS
Hepatobiliary MDT-style case discussion on obstruction level and drainage decision-making.
Related topics
Hepatobiliary
Percutaneous cholecystostomy as a clinical concept — its role as an alternative to surgery in high-risk acute cholecystitis, and the shared decision-making this involves.
Why it matters. It is a common bridging or definitive option for patients unfit for surgery, and a frequent after-hours referral to IR from surgical teams.
Learning objectives
Related topics
Enteric access
Image-guided gastrostomy and enteric access as a clinical concept — supporting nutrition in patients who cannot swallow safely, and the multidisciplinary referral pathway involved.
Why it matters. Enteral access is central to nutrition support in neurological, oncological and critical-care patients, and a frequent dietetics/speech-therapy-led referral.
Learning objectives
Deeper, often observational exposure for senior registrars and consultants developing an IR interest.
Interventional oncology
An introduction to interventional oncology — ablation and transarterial therapy categories — as principles and their place in multidisciplinary cancer care.
Why it matters. Interventional oncology is a fast-growing area with its own curriculum and certification track; early orientation helps registrars explore it.
Learning objectives
Related topics
Interventional oncology
An orientation to image-guided tumour ablation as a treatment category — the broad energy-source families and the tumour-board discussion that selects patients for it.
Why it matters. Ablation is now a standard option in several tumour-board algorithms; registrars benefit from recognising when and why it is discussed as an alternative to surgery.
Learning objectives
Related topics
Device care
An orientation to the common problems seen with indwelling tubes and drains — blockage, displacement and leakage — and the clinical reasoning used to assess them before any exchange or removal decision.
Why it matters. Ward and on-call teams raise tube and drain problems constantly; a clinical-reasoning framework reduces unnecessary urgent IR referrals and improves patient safety.
Learning objectives
Related topics
Every pillar connects to the training and career pathways that follow registrar learning — from supervised exposure to certification and beyond.