2025 Hexarad Scholarship winner

Dr Nemat Ali Ahmad is the winner of the 2025 Hexarad Scholarship. His winning essay is on interventional radiology, which is a growing sub-specialty of clinical radiology transforming patient care through minimally invasive, image-guided treatment.

Interventional radiology (IR) is one of the most transformative and versatile specialties in being the frontline of innovation in medicine. It remains underrepresented and, perplexingly, much of what it offers is still unknown to many clinicians. Fortunately, I discovered this hidden gem during my FY1 Taster Week at QEUH.

I watched minimally invasive procedures changing lives in real time. What stood out was the fusion of cutting-edge technology with real clinical impact. As a child, I remember my father describing how my grandmother didn’t survive ‘open heart surgery’ at the start of the millennium. Decades later, I witnessed a neurointerventionalist using guided augmented 3D imaging to place a flowdiverter into a stroke patient’s brain via a tiny hole in the leg.

AI is often seen as a buzzword, but in IR, it’s already reshaping care. I shadowed a live procedure where a rare ACA aneurysm holographic reconstruction was used to guide intervention. I was also shown upcoming cases using AI-generated overlays to plan needle trajectories for spinal nerve blocks and tumour biopsies with sub-millimetre accuracy. It felt like science fiction. I glimpsed the future.

One conversation about fluoroscopy left a mark. The team explained how IR constantly balances radiation risk with diagnostic benefit. I found myself wondering, could we reduce radiation altogether? I’ve always enjoyed physics, so I was sceptical. Surely we require X-rays for deep tissue penetration? I researched Philips’ Fibre Optic RealShape (FORS) technology, which enables live 3D visualisation of devices without continuous fluoroscopy. While X-rays are still needed for mapping, FORS could reduce net radiation significantly. This could make IR safer for groups once deemed high risk, particularly pregnant patients. Innovation happens in steps, and we’re heading in the right direction.

IR’s reach into other disciplines is expanding, and I am inspired. Gastric artery embolisation for appetite suppression and intravascular lithotripsy for calcified vessels are examples of how IR could help tackle chronic diseases. Proton beam therapy is redefining radioncology by offering precision with fewer long term side effects, especially for paediatric and anatomically complex tumours.

Unlike ‘open heart surgery’, modern endovascular techniques offer high-impact treatment with minimal resources, an approach that could be scaled to low-resource settings globally. A procedure done through the femoral artery could transform care in countries that lack operating theatres. IR contributes to environmental sustainability by reducing hospital stays, unnecessary imaging and invasive surgery, ultimately lowering healthcare’s carbon footprint in line with Hexarad’s net-zero goals.

Potential advancements in the future of IR have cemented my goal of playing an active role in shaping the field. Its adaptability is not just technological, but financial and socioecological. As a foundation doctor from a BAME background, I’ve seen how opportunities in emerging specialties are not always equally accessible. By securing my role as BSIR FY1 representative, I’ve committed to breaking down these barriers and advocating for greater representation, equity, and access to IR training. In the next decade, I plan to join the movement that ensures the specialty grows not just in innovation, but in inclusion.