Advancements in Microwave Ablation Techniques for Managing Pancreatic Lesions
Abstract
:1. Introduction
2. Background
3. Technique
3.1. Radiofrequency Ablation
3.2. Photodynamic Therapy
3.3. High-Intensity Focused Ultrasound
3.4. Cryothermal Ablation
4. Microwave Ablation of Pancreatic Lesions
4.1. Pancreatic Cancer
4.2. Pancreatic Neuroendocrine Tumors
4.3. Pancreatic Cystic Lesions
5. Discussion
Microwave Ablation Studies | Cumulative Complication Rate (%) | ||||
---|---|---|---|---|---|
N | Complications | MWA | RFA | Chemoablation | |
PC | 54 | Abdominal pain (n = 2) Mild pancreatitis (n = 5) Asymptomatic hyperamylasemia (n = 1) Pancreatic ascites/fluid collection (n = 2) Minor bleeding (n = 1) Pseudoaneurysm of gastroduodenal artery (n = 1) | 22% | 27% [7] | 35% [72] |
pNET | 11 | Pseudocyst (n = 2) Pancreatic fistula (n = 1) Mild acute pancreatitis (n = 1) | 36% | 11% [7] | 17% 1 [67] |
PCL | 0 | N/A | N/A | 20% [73] | 14% 2 [74] |
6. Future Directions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Benson, A.B., 3rd; Abrams, T.A.; Ben-Josef, E.; Bloomston, P.M.; Botha, J.F.; Clary, B.M.; Covey, A.; Curley, S.A.; D’Angelica, M.I.; Davila, R.; et al. NCCN clinical practice guidelines in oncology: Hepatobiliary cancers. J. Natl. Compr. Cancer Netw. JNCCN 2009, 7, 350–391. [Google Scholar] [CrossRef] [PubMed]
- European Association for the Study of the Liver. EASL–EORTC clinical practice guidelines: Management of hepatocellular carcinoma. J. Hepatol. 2012, 56, 908–943. [Google Scholar] [CrossRef] [PubMed]
- Welch, B.T.; Shah, P.H.; Thompson, R.H.; Atwell, T.D. The current status of thermal ablation in the management of T1b renal masses. Int. J. Hyperth. 2019, 36, 31–36. [Google Scholar] [CrossRef] [PubMed]
- Papini, E.; Monpeyssen, H.; Frasoldati, A.; Hegedüs, L. 2020 European thyroid association clinical practice guideline for the use of image-guided ablation in benign thyroid nodules. Eur. Thyroid J. 2020, 9, 172–185. [Google Scholar] [CrossRef]
- Ye, X.; Fan, W.; Wang, Z.; Wang, J.; Wang, H.; Wang, J.; Wang, C.; Niu, L.; Fang, Y.; Gu, S.; et al. Expert consensus on thermal ablation therapy of pulmonary subsolid nodules (2021 Edition). J. Cancer Res. Ther. 2021, 17, 1141–1156. [Google Scholar] [CrossRef]
- Testoni, S.G.G.; Healey, A.J.; Dietrich, C.F.; Arcidiacono, P.G. Systematic review of endoscopy ultrasound-guided thermal ablation treatment for pancreatic cancer. Endosc Ultrasound 2020, 9, 83–100. [Google Scholar]
- Karaisz, F.G.; Elkelany, O.O.; Davies, B.; Lozanski, G.; Krishna, S.G. A Review on Endoscopic Ultrasound-Guided Radiofrequency Ablation (EUS-RFA) of Pancreatic Lesions. Diagnostics 2023, 13, 536. [Google Scholar] [CrossRef]
- Fahmawi, Y.; Mehta, A.; Abdalhadi, H.; Merritt, L.; Mizrahi, M. Efficacy and safety of endoscopic ultrasound-guided radiofrequency ablation for management of pancreatic lesions: A systematic review and meta-analysis. Transl. Gastroenterol. Hepatol. 2022, 7, 30. [Google Scholar] [CrossRef]
- Yousaf, M.N.; Ehsan, H.; Muneeb, A.; Wahab, A.; Sana, M.K.; Neupane, K.; Chaudhary, F.S. Role of radiofrequency ablation in the management of unresectable pancreatic cancer. Front. Med. 2021, 7, 1070. [Google Scholar] [CrossRef]
- Wang, L.; Xu, J.; Yu, J.; Liang, P. Review of clinical tumor ablation advance in Asia. Int. J. Hyperth. 2021, 38, 1639–1649. [Google Scholar] [CrossRef]
- Simon, C.J.; Dupuy, D.E.; Mayo-Smith, W.W. Microwave ablation: Principles and applications. Radiographics 2005, 25 (Suppl. S1), S69–S83. [Google Scholar] [CrossRef] [PubMed]
- Wright, A.S.; Lee, F.T.; Mahvi, D.M. Hepatic microwave ablation with multiple antennae results in synergistically larger zones of coagulation necrosis. Ann. Surg. Oncol. 2003, 10, 275–283. [Google Scholar] [CrossRef] [PubMed]
- Skinner, M.G.; Iizuka, M.N.; Kolios, M.C.; Sherar, M.D. A theoretical comparison of energy sources-microwave, ultrasound and laser-for interstitial thermal therapy. Phys. Med. Biol. 1998, 43, 3535. [Google Scholar] [CrossRef] [PubMed]
- Shock, S.A.; Meredith, K.; Warner, T.F.; Sampson, L.A.; Wright, A.S.; Winter, T.C., 3rd; Mahvi, D.M.; Fine, J.P.; Lee, F.T., Jr. Microwave ablation with loop antenna: In vivo porcine liver model. Radiology 2004, 231, 143–149. [Google Scholar] [CrossRef] [PubMed]
- Carrafiello, G.; Laganà, D.; Mangini, M.; Fontana, F.; Dionigi, G.; Boni, L.; Rovera, F.; Cuffari, S.; Fugazzola, C. Microwave tumors ablation: Principles, clinical applications and review of preliminary experiences. Int. J. Surg. 2008, 6, S65–S69. [Google Scholar] [CrossRef]
- Izzo, F.; Granata, V.; Grassi, R.; Fusco, R.; Palaia, R.; Delrio, P.; Carrafiello, G.; Azoulay, D.; Petrillo, A.; Curley, S.A. Radiofrequency Ablation and Microwave Ablation in Liver Tumors: An Update. Oncol. 2019, 24, e990–e1005. [Google Scholar] [CrossRef]
- Radosevic, A.; Quesada, R.; Serlavos, C.; Sánchez, J.; Zugazaga, A.; Sierra, A.; Coll, S.; Busto, M.; Aguilar, G.; Flores, D.; et al. Microwave versus radiofrequency ablation for the treatment of liver malignancies: A randomized controlled phase 2 trial. Sci. Rep. 2022, 12, 316. [Google Scholar] [CrossRef]
- Xu, W.; Li, S.; Cheng, F.; Gong, L.; Tang, W.; Lu, J.; Li, Y.; Wang, Z. Microwave ablation versus radiofrequency ablation for patients with primary and secondary hyperparathyroidism: A meta-analysis. Int. Urol. Nephrol. 2023, 55, 2237–2247. [Google Scholar] [CrossRef]
- Shi, F.; Li, G.; Zhou, Z.; Xu, R.; Li, W.; Zhuang, W.; Chen, Z.; Chen, X. Microwave ablation versus radiofrequency ablation for the treatment of pulmonary tumors. Oncotarget 2017, 8, 109791–109798. [Google Scholar] [CrossRef]
- Pandolfo, S.D.; Carbonara, U.; Beksac, A.T.; Derweesh, I.; Celia, A.; Schiavina, R.; Elbich, J.; Basile, G.; Hampton, L.J.; Cerrato, C.; et al. Microwave versus cryoablation and radiofrequency ablation for small renal mass: A multicenter comparative analysis. Minerva Urol. Nephrol. 2023, 75, 66–72. [Google Scholar] [CrossRef]
- Granata, V.; Grassi, R.; Fusco, R.; Belli, A.; Palaia, R.; Carrafiello, G.; Miele, V.; Grassi, R.; Petrillo, A.; Izzo, F. Local ablation of pancreatic tumors: State of the art and future perspectives. World J. Gastroenterol. 2021, 27, 3413. [Google Scholar] [CrossRef] [PubMed]
- Seki, T.; Wakabayashi, M.; Nakagawa, T.; Itho, T.; Shiro, T.; Kunieda, K.; Sato, M.; Uchiyama, S.; Inoue, K. Ultrasonically guided percutaneous microwave coagulation therapy for small hepatocellular carcinoma. Cancer 1994, 74, 817–825. [Google Scholar] [CrossRef] [PubMed]
- Carrafiello, G.; Ierardi, A.M.; Fontana, F.; Petrillo, M.; Floridi, C.; Lucchina, N.; Cuffari, S.; Dionigi, G.; Rotondo, A.; Fugazzola, C. Microwave Ablation of Pancreatic Head Cancer: Safety and Efficacy. J. Vasc. Interv. Radiol. 2013, 24, 1513–1520. [Google Scholar] [CrossRef] [PubMed]
- Ierardi, A.M.; Biondetti, P.; Coppola, A.; Fumarola, E.M.; Biasina, A.M.; Alessio Angileri, S.; Carrafiello, G. Percutaneous microwave thermosphere ablation of pancreatic tumours. Gland. Surg. 2018, 7, 59–66. [Google Scholar] [CrossRef]
- D’Amico, F.; Finotti, M.; Di Renzo, C.; Pasquale, A.; Bertacco, A.; Caturegli, G.; Gondolesi, G.E.; Cillo, U. Microwave Thermal Ablation in an Unusual Case of Malignant and Locally Advanced Rare Tumor of Pancreas in ASA IV Old Male Patient and Literature Review. Case Rep. Gastrointest. Med. 2018, 2018, 6064912. [Google Scholar] [CrossRef]
- Lygidakis, N.J.; Sharma, S.K.; Papastratis, P.; Zivanovic, V.; Kefalourous, H.; Koshariya, M.; Lintzeris, I.; Porfiris, T.; Koutsiouroumba, D. Microwave ablation in locally advanced pancreatic carcinoma—A new look. Hepato-gastroenterology 2007, 54, 1305–1310. [Google Scholar]
- Robles-Medranda, C.; Arevalo-Mora, M.; Oleas, R.; Alcivar-Vasquez, J.; Del Valle, R. Novel EUS-guided microwave ablation of an unresectable pancreatic neuroendocrine tumor. VideoGIE 2022, 7, 74–76. [Google Scholar] [CrossRef]
- Carrafiello, G.; Ierardi, A.M.; Piacentino, F.; Lucchina, N.; Dionigi, G.; Cuffari, S.; Fugazzola, C. Microwave Ablation with Percutaneous Approach for the Treatment of Pancreatic Adenocarcinoma. CardioVascular Interv. Radiol. 2012, 35, 439–442. [Google Scholar] [CrossRef]
- Chen, O.T.; Dojki, F.K.; Weber, S.M.; Hinshaw, J.L. Percutaneous Microwave Ablation of an Insulinoma in a Patient with Refractory Symptomatic Hypoglycemia. J. Gastrointest. Surg. 2015, 19, 1378–1381. [Google Scholar] [CrossRef]
- Murtha, T.D.; Cornman-Homonoff, J.; Ayyagari, R.; Zhang, X.; Salem, R.R. A Novel Treatment for Metastatic Serous Cystadenocarcinoma Using a Microwave Ablation: Case Report and Review of the Literature. Pancreas 2021, 50, 434–440. [Google Scholar] [CrossRef]
- Jayawickreme, K.P.; Muthukuda, D.T.; Kariyawasam, C.; Piyarisi, L.; Abeywickrama, B.A. A rare case of insulinoma presenting with deep vein thrombosis, successfully treated with minimally invasive procedures including microwave ablation. Endocrinol. Diabetes Metab. Case Rep. 2022, 2022, 21–0127. [Google Scholar] [CrossRef]
- Simo, K.A.; Tsirline, V.B.; Sindram, D.; McMillan, M.T.; Thompson, K.J.; Swan, R.Z.; McKillop, I.H.; Martinie, J.B.; Iannitti, D.A. Microwave ablation using 915-MHz and 2.45-GHz systems: What are the differences? HPB 2013, 15, 991–996. [Google Scholar] [CrossRef]
- Chu, K.F.; Dupuy, D.E. Thermal ablation of tumours: Biological mechanisms and advances in therapy. Nat. Rev. Cancer 2014, 14, 199–208. [Google Scholar] [CrossRef]
- Paiella, S.; Salvia, R.; Ramera, M.; Girelli, R.; Frigerio, I.; Giardino, A.; Allegrini, V.; Bassi, C. Local ablative strategies for ductal pancreatic cancer (radiofrequency ablation, irreversible electroporation): A review. Gastroenterol. Res. Pract. 2016, 2016, 4508376. [Google Scholar] [CrossRef] [PubMed]
- Wright, A.S.; Sampson, L.A.; Warner, T.F.; Mahvi, D.M.; Lee, F.T., Jr. Radiofrequency versus microwave ablation in a hepatic porcine model. Radiology 2005, 236, 132–139. [Google Scholar] [CrossRef]
- Choi, J.H.; Oh, D.; Lee, J.H.; Park, J.H.; Kim, K.P.; Lee, S.S.; Lee, Y.J.; Lim, Y.S.; Song, T.J.; Lee, S.S.; et al. Initial human experience of endoscopic ultrasound-guided photodynamic therapy with a novel photosensitizer and a flexible laser-light catheter. Endoscopy 2015, 47, 1035–1038. [Google Scholar] [CrossRef]
- Algorri, J.F.; Ochoa, M.; Roldán-Varona, P.; Rodríguez-Cobo, L.; López-Higuera, J.M. Photodynamic Therapy: A Compendium of Latest Review. Cancers 2021, 13, 4447. [Google Scholar] [CrossRef]
- Zhou, Y.-F. High intensity focused ultrasound in clinical tumor ablation. World J. Clin. Oncol. 2011, 2, 8. [Google Scholar] [CrossRef]
- Izadifar, Z.; Izadifar, Z.; Chapman, D.; Babyn, P. An introduction to high intensity focused ultrasound: Systematic review on principles, devices, and clinical applications. J. Clin. Med. 2020, 9, 460. [Google Scholar] [CrossRef]
- Stanislavova, N.; Karamanliev, M.; Ivanov, T.; Yotsov, T.; Zhou, K.; Dimitrov, D. Is high-intensity focused ultrasound (HIFU) an option for neoadjuvant therapy for borderline resectable pancreatic cancer patients? a systematic review. Int. J. Hyperth. 2021, 38, 75–80. [Google Scholar] [CrossRef]
- Testoni, S.G.G.; Capurso, G.; Petrone, M.C.; Barbera, M.; Linzenbold, W.; Enderle, M.; Gusmini, S.; Nicoletti, R.; Della Torre, E.; Mariani, A.; et al. Necrosis volume and Choi criteria predict the response to endoscopic ultrasonography-guided HybridTherm ablation of locally advanced pancreatic cancer. Endosc. Int. Open 2020, 8, E1511–E1519. [Google Scholar] [CrossRef]
- Arcidiacono, P.G.; Carrara, S.; Reni, M.; Petrone, M.C.; Cappio, S.; Balzano, G.; Boemo, C.; Cereda, S.; Nicoletti, R.; Enderle, M.D.; et al. Feasibility and safety of EUS-guided cryothermal ablation in patients with locally advanced pancreatic cancer. Gastrointest. Endosc. 2012, 76, 1142–1151. [Google Scholar] [CrossRef]
- Testoni, S.G.G.; Petrone, M.C.; Reni, M.; Rossi, G.; Barbera, M.; Nicoletti, V.; Gusmini, S.; Balzano, G.; Linzenbold, W.; Enderle, M.; et al. Efficacy of endoscopic ultrasound-guided ablation with the HybridTherm probe in locally advanced or borderline resectable pancreatic cancer: A phase II randomized controlled trial. Cancers 2021, 13, 4512. [Google Scholar] [CrossRef]
- Viale, P.H. The American Cancer Society’s facts & figures: 2020 edition. J. Adv. Pract. Oncol. 2020, 11, 135. [Google Scholar]
- Siegel, R.L.; Miller, K.D.; Fuchs, H.E.; Jemal, A. Cancer statistics 2021. CA Cancer J. Clin. 2021, 71, 7–33. [Google Scholar] [CrossRef]
- Scopelliti, F.; Pea, A.; Conigliaro, R.; Butturini, G.; Frigerio, I.; Regi, P.; Giardino, A.; Bertani, H.; Paini, M.; Pederzoli, P.; et al. Technique, safety, and feasibility of EUS-guided radiofrequency ablation in unresectable pancreatic cancer. Surg. Endosc. 2018, 32, 4022–4028. [Google Scholar] [CrossRef]
- Vogl, T.J.; Panahi, B.; Albrecht, M.H.; Naguib, N.N.N.; Nour-Eldin, N.A.; Gruber-Rouh, T.; Thompson, Z.M.; Basten, L.M. Microwave ablation of pancreatic tumors. Minim. Invasive Ther. Allied Technol. 2018, 27, 33–40. [Google Scholar] [CrossRef]
- Halfdanarson, T.R.; Rubin, J.; Farnell, M.B.; Grant, C.S.; Petersen, G.M. Pancreatic endocrine neoplasms: Epidemiology and prognosis of pancreatic endocrine tumors. Endocr. -Relat. Cancer 2008, 15, 409. [Google Scholar] [CrossRef]
- Bharath, S.; Carpenter, A.; Yadav, S.K.; Agarwal, V.; Somashekhar, U.; Sharma, D. Role of Endoscopic Ultrasound Ablative Therapy in Management of Pancreatic Neuroendocrine Tumors: A Systematic Review. Indian J. Surg. 2022, 1–6. [Google Scholar] [CrossRef]
- Mele, C.; Brunani, A.; Damascelli, B.; Tichà, V.; Castello, L.; Aimaretti, G.; Scacchi, M.; Marzullo, P. Non-surgical ablative therapies for inoperable benign insulinoma. J. Endocrinol. Investig. 2018, 41, 153–162. [Google Scholar] [CrossRef]
- Koshy, A.A.; Gordon, I.O.; Van Ha, T.G.; Kaplan, E.L.; Philipson, L.H. Metastatic Insulinoma Following Resection of Nonsecreting Pancreatic Islet Cell Tumor: A Case Report and Review of the Literature. J. Investig. Med. High Impact Case Rep. 2013, 1, 2324709612473274. [Google Scholar] [CrossRef] [PubMed]
- Howe, J.R.; Merchant, N.B.; Conrad, C.; Keutgen, X.M.; Hallet, J.; Drebin, J.A.; Minter, R.M.; Lairmore, T.C.; Tseng, J.F.; Zeh, H.J.; et al. The North American Neuroendocrine Tumor Society consensus paper on the surgical management of pancreatic neuroendocrine tumors. Pancreas 2020, 49, 1–33. [Google Scholar] [CrossRef] [PubMed]
- Egorov, A.V.; Vasilyev, I.A.; Musayev, G.H.; Mironova, A.V. The role of microwave ablation in management of functioning pancreatic neuroendocrine tumors. Gland. Surg. 2019, 8, 766–772. [Google Scholar] [CrossRef] [PubMed]
- Tanaka, M.; Fernández-Del Castillo, C.; Kamisawa, T.; Jang, J.Y.; Levy, P.; Ohtsuka, T.; Salvia, R.; Shimizu, Y.; Tada, M.; Wolfgang, C.L. Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatology 2017, 17, 738–753. [Google Scholar] [CrossRef] [PubMed]
- Ardeshna, D.R.; Cao, T.; Rodgers, B.; Onongaya, C.; Jones, D.; Chen, W.; Koay, E.J.; Krishna, S.G. Recent advances in the diagnostic evaluation of pancreatic cystic lesions. World J. Gastroenterol. 2022, 28, 624. [Google Scholar] [CrossRef]
- Keane, M.G.; Afghani, E. A review of the diagnosis and management of premalignant pancreatic cystic lesions. J. Clin. Med. 2021, 10, 1284. [Google Scholar] [CrossRef]
- Aziz, H.; Acher, A.W.; Krishna, S.G.; Cloyd, J.M.; Pawlik, T.M. Comparison of society guidelines for the management and surveillance of pancreatic cysts: A review. JAMA Surg. 2022, 157, 723–730. [Google Scholar] [CrossRef]
- Ånonsen, K.; Sahakyan, M.A.; Kleive, D.; Waage, A.; Verbeke, C.; Hauge, T.; Buanes, T.; Edwin, B.; Labori, K.J. Trends in management and outcome of cystic pancreatic lesions–analysis of 322 cases undergoing surgical resection. Scand. J. Gastroenterol. 2019, 54, 1051–1057. [Google Scholar] [CrossRef]
- Ardeshna, D.R.; Woods, E.; Tsung, A.; Krishna, S.G. An update on EUS-guided ablative techniques for pancreatic cystic lesions. Endosc. Ultrasound 2022, 11, 432–441. [Google Scholar]
- Shiina, S.; Sato, K.; Tateishi, R.; Shimizu, M.; Ohama, H.; Hatanaka, T.; Takawa, M.; Nagamatsu, H.; Imai, Y. Percutaneous ablation for hepatocellular carcinoma: Comparison of various ablation techniques and surgery. Can. J. Gastroenterol. Hepatol. 2018, 2018, 4756147. [Google Scholar] [CrossRef]
- Brace, C.L.; Laeseke, P.F.; Sampson, L.A.; Frey, T.M.; van der Weide, D.W.; Lee, F.T., Jr. Microwave ablation with a single small-gauge triaxial antenna: In vivo porcine liver model. Radiology 2007, 242, 435–440. [Google Scholar] [CrossRef] [PubMed]
- Fan, W.; Li, X.; Zhang, L.; Jiang, H.; Zhang, J. Comparison of microwave ablation and multipolar radiofrequency ablation in vivo using two internally cooled probes. Am. J. Roentgenol. 2012, 198, W46–W50. [Google Scholar] [CrossRef] [PubMed]
- Dodd, G.D., 3rd; Dodd, N.A.; Lanctot, A.C.; Glueck, D.A. Effect of variation of portal venous blood flow on radiofrequency and microwave ablations in a blood-perfused bovine liver model. Radiology 2013, 267, 129–136. [Google Scholar] [CrossRef] [PubMed]
- D’Onofrio, M.; Beleù, A.; Sarno, A.; De Robertis, R.; Paiella, S.; Viviani, E.; Frigerio, I.; Girelli, R.; Salvia, R.; Bassi, C. US-guided percutaneous radiofrequency ablation of locally advanced pancreatic adenocarcinoma: A 5 year high volume center experience. Ultraschall Der Med.-Eur. J. Ultrasound 2022, 43, 380–386. [Google Scholar] [CrossRef]
- Girelli, R.; Frigerio, I.; Salvia, R.; Barbi, E.; Tinazzi Martini, P.; Bassi, C. Feasibility and safety of radiofrequency ablation for locally advanced pancreatic cancer. J. Br. Surg. 2010, 97, 220–225. [Google Scholar] [CrossRef] [PubMed]
- Garg, R.; Mohammed, A.; Singh, A.; Harnegie, M.P.; Rustagi, T.; Stevens, T.; Chahal, P. EUS-guided radiofrequency and ethanol ablation for pancreatic neuroendocrine tumors: A systematic review and meta-analysis. Endosc. Ultrasound 2022, 11, 170–185. [Google Scholar] [CrossRef] [PubMed]
- Elkelany, O.O.; Karaisz, F.G.; Davies, B.; Krishna, S.G. An Overview of Pancreatic Neuroendocrine Tumors and an Update on Endoscopic Techniques for Their Management. Curr. Oncol. 2023, 30, 7566–7580. [Google Scholar] [CrossRef]
- Barthet, M.; Giovannini, M.; Lesavre, N.; Boustiere, C.; Napoleon, B.; Koch, S.; Gasmi, M.; Vanbiervliet, G.; Gonzalez, J.M. Endoscopic ultrasound guided radiofrequency ablaion for pancreatic neuroendocrine tumors and pancreatic cystic neoplasms: A prospective multicenter study. Endoscopy 2019, 51, 836–842. [Google Scholar]
- Barthet, M.; Giovannini, M.; Gasmi, M.; Lesavre, N.; Boustière, C.; Napoleon, B.; LaQuiere, A.; Koch, S.; Vanbiervliet, G.; Gonzalez, J.M. Long term outcome after EUS-guided radiofrequency ablation: Prospective results in pancreatic neuroendocrine tumors and pancreatic cystic neoplasms. Endosc. Int. Open 2021, 9, e1178–e1185. [Google Scholar] [CrossRef]
- Papaefthymiou, A.; Johnson, G.J.; Maida, M.; Gkolfakis, P.; Ramai, D.; Facciorusso, A.; Arvanitakis, M.; Ney, A.; Fusai, G.K.; Saftoiu, A.; et al. Performance and Safety of EUS Ablation Techniques for Pancreatic Cystic Lesions: A Systematic Review and Meta-Analysis. Cancers 2023, 15, 2627. [Google Scholar] [CrossRef]
- Bispo, M.; Caldeira, A.; Leite, S.; Marques, S.; Moreira, T.; Moutinho-Ribeiro, P.; Nunes, N. Endoscopic ultrasound-guided ablation of focal pancreatic lesions: The GRUPUGE perspective. GE-Port. J. Gastroenterol. 2020, 27, 410–416. [Google Scholar] [CrossRef] [PubMed]
- Signoretti, M.; Valente, R.; Repici, A.; Delle Fave, G.; Capurso, G.; Carrara, S. Endoscopy-guided ablation of pancreatic lesions: Technical possibilities and clinical outlook. World J. Gastrointest Endosc. 2017, 9, 41–54. [Google Scholar] [CrossRef] [PubMed]
- Alvarez-Sánchez, M.V.; Napoléon, B. Review of endoscopic radiofrequency in biliopancreatic tumours with emphasis on clinical benefits, controversies and safety. World J. Gastroenterol. 2016, 22, 8257–8270. [Google Scholar] [CrossRef] [PubMed]
- Koehler, B.; Ryoo, D.Y.; Krishna, S.G. A Review of Endoscopic Ultrasound-Guided Chemoablative Techniques for Pancreatic Cystic Lesions. Diagnostics 2023, 13, 344. [Google Scholar] [CrossRef]
Ethanol/Chemoablation | RFA | MWA | |
---|---|---|---|
Approach | |||
EUS-guided | x | x | x |
Percutaneous | x | x | |
Laparotomy | x | x | |
Timing of necrosis | Delayed | Immediate | Immediate |
Theoretical Aspects [61,62,63] | |||
Ablation Volume | Dependent on cyst size | Small to medium | Large |
Temperature | N/A | Low | High |
Heat Sink Effect | N/A | More | Less |
Need for cooling probe tip | N/A | Yes | Optional |
Target Lesion | PCLs | PCLs, pNETS, PCs | pNETS, PCs PCLs (no data yet) |
Gaps in Knowledge | Existing Data |
---|---|
Comparison of laparotomy, percutaneous, and EUS-guided approach | None |
Microwave ablation in PCLs | None |
Long-term efficacy data | Limited data to pNETs |
EUS-guided microwave ablation | Limited data to pNETs |
Effect of technical modification on efficacy and safety of microwave ablation | Data in non-pancreatic lesions |
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Ardeshna, D.R.; Leupold, M.; Cruz-Monserrate, Z.; Pawlik, T.M.; Cloyd, J.M.; Ejaz, A.; Shah, H.; Burlen, J.; Krishna, S.G. Advancements in Microwave Ablation Techniques for Managing Pancreatic Lesions. Life 2023, 13, 2162. https://doi.org/10.3390/life13112162
Ardeshna DR, Leupold M, Cruz-Monserrate Z, Pawlik TM, Cloyd JM, Ejaz A, Shah H, Burlen J, Krishna SG. Advancements in Microwave Ablation Techniques for Managing Pancreatic Lesions. Life. 2023; 13(11):2162. https://doi.org/10.3390/life13112162
Chicago/Turabian StyleArdeshna, Devarshi R., Matthew Leupold, Zobeida Cruz-Monserrate, Timothy M. Pawlik, Jordan M. Cloyd, Aslam Ejaz, Hamza Shah, Jordan Burlen, and Somashekar G. Krishna. 2023. "Advancements in Microwave Ablation Techniques for Managing Pancreatic Lesions" Life 13, no. 11: 2162. https://doi.org/10.3390/life13112162