EUS-guided radiofrequency ablation for management of pancreatic insulinoma by using a novel needle electrode (with videos) Sundeep Lakhtakia, DM, Mohan.

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Presentation transcript:

EUS-guided radiofrequency ablation for management of pancreatic insulinoma by using a novel needle electrode (with videos) Sundeep Lakhtakia, DM, Mohan Ramchandani, DM, Domenico Galasso, MD, Rajesh Gupta, DM, Sushma Venugopal, MD, Rakesh Kalpala, DNB, D. Nageshwar Reddy, DM Gastrointestinal Endoscopy Volume 83, Issue 1, Pages 234-239 (January 2016) DOI: 10.1016/j.gie.2015.08.085 Copyright © 2016 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 A, Needle electrode (EUS-guided radiofrequency ablation). B, Close-up of the tip of the needle electrode showing the uncovered 1-cm tip. C, Needle electrode projecting from the echoendoscope tip. D, Handle of the needle electrode attached to the accessory channel of the echoendoscope. E, Viva Combo RFA generator, front view. F, Viva Combo RFA generator, side view. G, Viva pump. Gastrointestinal Endoscopy 2016 83, 234-239DOI: (10.1016/j.gie.2015.08.085) Copyright © 2016 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 A, Abdominal contrast-enhanced CT in the arterial phase shows an enhancing lesion (insulinoma) in the pancreatic genu (arrow). B, Well-defined hypoechoic oval-shaped lesion (insulinoma) in the pancreatic genu (arrow). Gastrointestinal Endoscopy 2016 83, 234-239DOI: (10.1016/j.gie.2015.08.085) Copyright © 2016 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 3 Post–EUS-guided radiofrequency ablation at 6 weeks. Contrast-enhanced CT shows a hypodense nonenhancing lesion in the genu of pancreas (arrow). Gastrointestinal Endoscopy 2016 83, 234-239DOI: (10.1016/j.gie.2015.08.085) Copyright © 2016 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 4 Post–EUS-guided radiofrequency ablation at 12 months. EUS shows a small residual hypoechoic lesion (arrow) with patchy echogenic areas. Gastrointestinal Endoscopy 2016 83, 234-239DOI: (10.1016/j.gie.2015.08.085) Copyright © 2016 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 5 Abdominal contrast-enhanced CT in the arterial phase shows a large enhancing lesion in the head and genu of the pancreas (arrow). Gastrointestinal Endoscopy 2016 83, 234-239DOI: (10.1016/j.gie.2015.08.085) Copyright © 2016 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 6 Post–EUS-guided radiofrequency ablation at 3 months. Abdominal contrast-enhanced CT shows a pancreatic head lesion with rim enhancement and a central nonenhancing hypodense area (arrow). Gastrointestinal Endoscopy 2016 83, 234-239DOI: (10.1016/j.gie.2015.08.085) Copyright © 2016 American Society for Gastrointestinal Endoscopy Terms and Conditions