EUS-guided pancreatic radiofrequency ablation: preclinical comparison of two currently available devices in a pig model

Introduction Two devices are currently available to perform pancreatic radiofrequency ablation (P-RFA). Potential clinical indications might extend from the treatment of pancreatic cystic lesions to ablation of small pancreatic solid lesions or cytoreduction of advanced pancreatic adenocarcinomas, b...

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Main Authors: Maximilien Barret, Sarah Leblanc, Alexandre Rouquette, Stanislas Chaussade, Benoit Terris, Frédéric Prat
Format: Article
Language:English
Published: Georg Thieme Verlag KG 2019-01-01
Series:Endoscopy International Open
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/a-0668-5653
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spelling doaj-365af5ea1fd74c9e9b383475a41a6bc82020-11-25T03:38:40ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362019-01-010702E138E14310.1055/a-0668-5653EUS-guided pancreatic radiofrequency ablation: preclinical comparison of two currently available devices in a pig modelMaximilien Barret0Sarah Leblanc1Alexandre Rouquette2Stanislas Chaussade3Benoit Terris4Frédéric Prat5Department of Gastroenterology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, FranceDepartment of Gastroenterology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, FranceDepartment of Pathology, Cochin Hospital, Paris, FranceDepartment of Gastroenterology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, FranceParis-Descartes University, Paris, FranceDepartment of Gastroenterology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, FranceIntroduction Two devices are currently available to perform pancreatic radiofrequency ablation (P-RFA). Potential clinical indications might extend from the treatment of pancreatic cystic lesions to ablation of small pancreatic solid lesions or cytoreduction of advanced pancreatic adenocarcinomas, but more preclinical data from animal models are needed to optimize P-RFA operation. Methods P-RFA was performed under laparotomy and under endoscopic ultrasonographic guidance on the liver and pancreatic parenchyma of four live swine using the Habib EUS RFA (EMcision Ltd, London, UK) probe and the EUS-RA needle (Taewoong Medical, Gyeonggi-do, South Korea). Animals were sacrificed 2 hours after the procedure. Influence of tuning ablation time and power on tissue ablation were studied by histopathological assessment of the maximal depth of tissue damage on representative slides for each P-RFA shot. Results The Habib probe in the liver parenchyma resulted in tissue necrosis increasing within the range of 1.9 ± 0.5 mm (Power = 8 W, Time = 120 s) to 2.5 ± 1 mm (Power = 10 W, Time = 120 s). In the pancreatic parenchyma, tissue damage ranged from 3.1 ± 0.4 mm (Power = 8 W, Time = 120 s) to 2.3 ± 0.1 mm (12 W, 120 s) in depth. EUS RFA ablation of the liver parenchyma resulted in tissue damage ranging from 1.6 ± 0.2 mm (Power = 30 W, Time = 11 s) to 1.5 ± 0.1 mm (Power = 70 W, Time = 9 s); in the pancreas, ablation depth ranged from 3.6 ± 0.5 mm (Power = 30 W, Time = 15 s) to 3.8 ± 0.4 mm (Power = 70 W, Time = 11 s). Conclusion Both devices allow for effective ablation of pancreatic tissue within 1.5 to 3.8 mm around the RFA electrode, with a modest influence of tuning power settings. Specific settings are recommended for each of the devices studied. Ablation of larger lesions may require more repeat P-RFA shots in different locations rather than a simple modulation of ablation parameters.http://www.thieme-connect.de/DOI/DOI?10.1055/a-0668-5653
collection DOAJ
language English
format Article
sources DOAJ
author Maximilien Barret
Sarah Leblanc
Alexandre Rouquette
Stanislas Chaussade
Benoit Terris
Frédéric Prat
spellingShingle Maximilien Barret
Sarah Leblanc
Alexandre Rouquette
Stanislas Chaussade
Benoit Terris
Frédéric Prat
EUS-guided pancreatic radiofrequency ablation: preclinical comparison of two currently available devices in a pig model
Endoscopy International Open
author_facet Maximilien Barret
Sarah Leblanc
Alexandre Rouquette
Stanislas Chaussade
Benoit Terris
Frédéric Prat
author_sort Maximilien Barret
title EUS-guided pancreatic radiofrequency ablation: preclinical comparison of two currently available devices in a pig model
title_short EUS-guided pancreatic radiofrequency ablation: preclinical comparison of two currently available devices in a pig model
title_full EUS-guided pancreatic radiofrequency ablation: preclinical comparison of two currently available devices in a pig model
title_fullStr EUS-guided pancreatic radiofrequency ablation: preclinical comparison of two currently available devices in a pig model
title_full_unstemmed EUS-guided pancreatic radiofrequency ablation: preclinical comparison of two currently available devices in a pig model
title_sort eus-guided pancreatic radiofrequency ablation: preclinical comparison of two currently available devices in a pig model
publisher Georg Thieme Verlag KG
series Endoscopy International Open
issn 2364-3722
2196-9736
publishDate 2019-01-01
description Introduction Two devices are currently available to perform pancreatic radiofrequency ablation (P-RFA). Potential clinical indications might extend from the treatment of pancreatic cystic lesions to ablation of small pancreatic solid lesions or cytoreduction of advanced pancreatic adenocarcinomas, but more preclinical data from animal models are needed to optimize P-RFA operation. Methods P-RFA was performed under laparotomy and under endoscopic ultrasonographic guidance on the liver and pancreatic parenchyma of four live swine using the Habib EUS RFA (EMcision Ltd, London, UK) probe and the EUS-RA needle (Taewoong Medical, Gyeonggi-do, South Korea). Animals were sacrificed 2 hours after the procedure. Influence of tuning ablation time and power on tissue ablation were studied by histopathological assessment of the maximal depth of tissue damage on representative slides for each P-RFA shot. Results The Habib probe in the liver parenchyma resulted in tissue necrosis increasing within the range of 1.9 ± 0.5 mm (Power = 8 W, Time = 120 s) to 2.5 ± 1 mm (Power = 10 W, Time = 120 s). In the pancreatic parenchyma, tissue damage ranged from 3.1 ± 0.4 mm (Power = 8 W, Time = 120 s) to 2.3 ± 0.1 mm (12 W, 120 s) in depth. EUS RFA ablation of the liver parenchyma resulted in tissue damage ranging from 1.6 ± 0.2 mm (Power = 30 W, Time = 11 s) to 1.5 ± 0.1 mm (Power = 70 W, Time = 9 s); in the pancreas, ablation depth ranged from 3.6 ± 0.5 mm (Power = 30 W, Time = 15 s) to 3.8 ± 0.4 mm (Power = 70 W, Time = 11 s). Conclusion Both devices allow for effective ablation of pancreatic tissue within 1.5 to 3.8 mm around the RFA electrode, with a modest influence of tuning power settings. Specific settings are recommended for each of the devices studied. Ablation of larger lesions may require more repeat P-RFA shots in different locations rather than a simple modulation of ablation parameters.
url http://www.thieme-connect.de/DOI/DOI?10.1055/a-0668-5653
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