Pancreatic ablation: minimally invasive treatment options

Figures & data

Figure 1. Case of a patient with symptomatic pancreatic adenocarcinoma treated with high intensity focused ultrasound. (a) Magnetic resonance Imaging demonstrating pathologic pancreatic mass. (b) PET/CT scan demonstrating high FDG uptake of the pancreatic tumor. (c) Treatment with US-guided high-intensity focused ultrasound. (d) PET/CT scan after treatment demonstrating lack of FDG uptake in the ablated area.

Table 1. Pros and cons of different image-guided ablative modalities for the treatment of pancreatic cancer.

	Pros	Cons
Invasive thermal techniques
Radiofrequency ablation	Largely available Literature available	Long procedure time Heat sink effect
Microwave ablation	Fast procedure time	No heat sink effect
Laser	Fast procedure time Fine needle positioning	Poor literature
Cryoablation	Near organs preservation Immunologic response stimulation	Long procedure time Large needle probes
Invasive non-thermal techniques
Irreversible electroporation	Poor vascular damage Fast procedure time	Needle positioning Small ablation volume
Non-invasive non-thermal techniques
High intensity focalized ultrasound	Non invasive	Poorly available Long procedure time Poor literature