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Thermal ablation of pancreatic cyst with a prototype endoscopic ultrasound capable radiofrequency needle device: A pilot feasibility study
- Source :
- Endoscopic Ultrasound
- Publication Year :
- 2017
- Publisher :
- Medknow Publications & Media Pvt Ltd, 2017.
-
Abstract
- Background and Objectives: Pancreatic cysts are evaluated by endoscopic ultrasound and fine needle aspiration (EUS). The only accepted treatment is pancreatectomy, which is associated with morbidity and mortality. This study evaluated the optimal thermal dosimetry of a novel radiofrequency ablation device using a standard electrosurgical unit in ex vivo cyst models. Methods: A modified EUS 22-gauge monopolar needle prototype with a tip electrode connected to a standard electrosurgical unit (Erbe USA, Marietta, GA, USA) was used to induce a subboiling point temperature. A cyst model was created using 2-cm sections of porcine small intestine ligated and filled with saline. After ablation, the cyst models were prepared for pathological evaluation. The epithelial layers were measured in at least two different sites with a micrometer and compared with the corresponding control sample. Results: Thirty-two cyst models were ablated with maximum temperatures of 50°C, 60°C, 90°C, and 97°C in 8, 11, 11, and 2 cysts, respectively. Longer ablation times were required to induce higher temperatures. A trend in the reduction in thickness of the measured layers was observed after exposure to higher temperatures. A temperature over 50°C was required for the ablation of the muscularis, submucosa, and villi, and over 60°C was required to ablate the mucosal crypts. Conclusions: In a preclinical model, a novel radiofrequency EUS-capable needle connected to a standard electrosurgical unit using standard low-voltage coagulation provided ablation in a temperature-dependent fashion with a threshold of at least 60°C and a safe cyst margin below 97°C. This potentially will allow low-cost, convenient cyst ablation.
- Subjects :
- Endoscopic ultrasound
medicine.medical_specialty
medicine.medical_treatment
Ablation
03 medical and health sciences
0302 clinical medicine
needle
Submucosa
medicine
Radiology, Nuclear Medicine and imaging
Cyst
pancreas
cyst
Hepatology
medicine.diagnostic_test
business.industry
Gastroenterology
medicine.disease
medicine.anatomical_structure
Fine-needle aspiration
030220 oncology & carcinogenesis
Pancreatectomy
030211 gastroenterology & hepatology
Original Article
Radiology
Pancreatic cysts
prototype
Nuclear medicine
business
Pancreas
Subjects
Details
- Language :
- English
- ISSN :
- 22267190 and 23039027
- Volume :
- 6
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Endoscopic Ultrasound
- Accession number :
- edsair.doi.dedup.....91d5e3de800355e82bdd4af123bc023b