Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Editorial
. 2010 Jul 28;16(28):3478-83.
doi: 10.3748/wjg.v16.i28.3478.

Radiofrequency ablation of locally advanced pancreatic adenocarcinoma: an overview

Mirko D'Onofrio  1 , Emilio Barbi, Roberto Girelli, Enrico Martone, Anna Gallotti, Roberto Salvia, Paolo-Tinazzi Martini, Claudio Bassi, Paolo Pederzoli, Roberto Pozzi Mucelli
Affiliations
Editorial

Radiofrequency ablation of locally advanced pancreatic adenocarcinoma: an overview

Mirko D'Onofrio et al. World J Gastroenterol. .

Abstract

Radiofrequency ablation (RFA) of pancreatic neoplasms is restricted to locally advanced, non-resectable but non-metastatic tumors. RFA of pancreatic tumors is nowadays an ultrasound-guided procedure performed during laparotomy in open surgery. Intraoperative ultrasound covers the mandatory role of staging, evaluation of feasibility, guidance and monitoring of the procedure. Different types of needle can be used. The first aim in the evaluation of RFA as a treatment for locally advanced pancreatic ductal adenocarcinoma, in order of evaluation but not of importance, is to determine the feasibility of the procedure. The second aim is to establish the effect of RFA on tumoral mass in terms of necrosis and cytoreduction. The most important aim, third in order of evaluation, is the potential improvement of quality of life and survival rate. Nowadays, only a few studies assess the feasibility of the procedure. The present paper is an overview of RFA for pancreatic adenocarcinoma.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Radiofrequency ablation procedure. Ultrasound-guided radiofrequency ablation performed during laparotomy in open surgery.
Figure 2
Figure 2
Intraoperative ultrasound monitoring. A: Needle with expandable electrodes is opened in the pancreatic hypoechoic mass under intraoperative ultrasound guidance; B: During radiofrequency ablation, the ablation zone becomes hyperechoic.
Figure 3
Figure 3
Needle with expandable electrodes. The electrodes can be opened into the lesion from the top (A) or from the back (B) of the needle.
Figure 4
Figure 4
Needle with single electrode. Single electrode of the needle in the lesion.
Figure 5
Figure 5
Pancreatic ductal adenocarcinoma after radiotherapy. A: Longitudinal color Doppler scan of the lesion, with hypoechoic infiltration of the superior mesenteric artery; B: Longitudinal contrast-enhanced ultrasonography scan of the hypovascular lesion.
Figure 6
Figure 6
Pancreatic ductal adenocarcinoma before and after radiofrequency ablation. A: Axial contrast-enhanced ultrasonography (US) scan of the hypovascular lesion; B: Axial contrast-enhanced US scan of the avascular lesion after radiofrequency ablation.
Figure 7
Figure 7
Pancreatic ductal adenocarcinoma before and after radiofrequency ablation. A: Contrast-enhanced computed tomography (CT) of pancreatic head lesion that appears hypodense and vascularized at perfusion CT (right side); B: Contrast-enhanced CT of the lesion after radiofrequency ablation, which appears hypodense and avascular at perfusion CT (right side).
Figure 8
Figure 8
Ablation zone on target lesion. A: Necrotic ablation zone (dotted grey) must covered the hepatocellular carcinoma (white); B: Necrotic ablation zone (dotted grey) must be included in the pancreatic ductal adenocarcinoma (grey).
See this image and copyright information in PMC

References

    1. Schima W, Ba-Ssalamah A, Kölblinger C, Kulinna-Cosentini C, Puespoek A, Götzinger P. Pancreatic adenocarcinoma. Eur Radiol. 2007;17:638–649. - PubMed
    1. Cubilla AL, Fitzgerald PJ. Tumors of the exocrine pancreas. In: Atlas of Tumor Pathology., editor. 2nd series, fascicle 19. Washington, DC: Armed Forces Institute of Pathology; 1984. pp. 98–108.
    1. O'Connor TP, Wade TP, Sunwoo YC, Reimers HJ, Palmer DC, Silverberg AB, Johnson FE. Small cell undifferentiated carcinoma of the pancreas. Report of a patient with tumor marker studies. Cancer. 1992;70:1514–1519. - PubMed
    1. Cameron JL. American Cancer Society Atlas of Clinical Oncology: Pancreatic Cancer. Hamilton, London: BC Decker; 2001.
    1. D'Onofrio M, Zamboni GA, Malagò R, Mantovani W, Principe F, Gallotti A, Faccioli N, Falconi M, Capelli P, Mucelli RP. Resectable pancreatic adenocarcinoma: is the enhancement pattern at contrast-enhanced ultrasonography a pre-operative prognostic factor? Ultrasound Med Biol. 2009;35:1929–1937. - PubMed

Publication types