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Review
. 2025 Jan 14;14(2):495.
doi: 10.3390/jcm14020495.

Endoscopic-Ultrasound-Guided Radiofrequency Ablation for Pancreatic Tumors

Chiara Coluccio  1 , Stefania Cappetta  2   3 , Giovanna Romagnoli  1   3 , Valentina Di Giorgio  2   3 , Paolo Giuffrida  1 , Stefano Fabbri  1 , Carlo Fabbri  1 , Cecilia Binda  1
Affiliations
Review

Endoscopic-Ultrasound-Guided Radiofrequency Ablation for Pancreatic Tumors

Chiara Coluccio et al. J Clin Med. .

Abstract

Endoscopic ultrasound (EUS)-guided radiofrequency ablation (RFA) is a promising minimally invasive technique for the treatment of pancreatic lesions. This review first focuses on the technical aspects in EUS-RFA: the procedure typically employs EUS probes with integrated radiofrequency electrodes, enabling accurate targeting and ablation of pancreatic lesions. Different types of RFA devices, monopolar and bipolar energy delivery systems, are discussed, along with considerations for optimal ablation, including energy settings, procedure time, and pre- and post-procedural management. This paper presents a comprehensive literature review of EUS-RFA applied to both solid and cystic pancreatic lesions, including functioning and non-functioning pancreatic neuroendocrine tumors (pNETs), pancreatic cystic lesions (PCLs), pancreatic ductal adenocarcinoma (PDAC), and pancreatic metastases (PMs), discussing current evidence on safety, efficacy, clinical outcomes, and adverse events (AEs). EUS-RFA is an emerging technique with expanding potential for the treatment of both benign and malignant conditions; however, further studies are needed to better define patient selection criteria, assess long-term benefits, and establish definitive indications for its use.

Keywords: ablation; endoscopic ultrasound; locoregional therapy; pancreas; radiofrequency.

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Conflict of interest statement

The following authors disclose financial relationships: C.C.: Speaker for Steris. C.B.: Speaker for Steris, Fujifilm, Boston Scientific, and Q3 Medical. C.F.: Consultant for Boston Scientific; speaker for Steris and Q3 Medical.

Figures

Figure 1
Figure 1
CH-EUS six-month follow-up in an asymptomatic patient after EUS-RFA on an insulinoma of the uncinate. (a) Time 0 corresponding to the injection of SonoVue®, (b) arterial phase with suspicion of millimetric residual disease, hypervascular in the image.
Figure 1
Figure 1
CH-EUS six-month follow-up in an asymptomatic patient after EUS-RFA on an insulinoma of the uncinate. (a) Time 0 corresponding to the injection of SonoVue®, (b) arterial phase with suspicion of millimetric residual disease, hypervascular in the image.
Figure 2
Figure 2
Six-month follow-up in an asymptomatic patient after EUS-RFA on an insulinoma of the uncinate: oval-shaped area with blurred margins and inhomogeneous hypo- and hyperechogenic structure.
See this image and copyright information in PMC

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