ASGE 2023 Masterclass EUS: Principles, Best Practices & Innovative Paradigms (On-Demand) | February 2023-EUS Ablation: Are We There Yet?

Video Transcription

Video Summary

The video discusses the use of EUS-guided ablation therapy for the treatment of pancreatic tumors. The speaker covers two main techniques: EOS-guided ethanol injection and radiofrequency ablation (RFA). The indications for ethanol injection include functional or non-functional neuroendocrine tumors (NET) larger than two centimeters, in patients who cannot undergo surgery or refuse it. Low-grade non-functional pancreatic neuroendocrine tumors smaller than two centimeters are also considered for ablation therapy. The speaker describes the technique for ethanol injection, which involves confirming the lesion's hypervascularity with contrast-enhanced EOS, injecting alcohol into the tumor, and assessing the efficacy using ultrasound imaging. The speaker also discusses the data on ethanol injection, reporting high response rates but some adverse events. RFA is another option for locally advanced pancreatic tumors. The technique involves advancing an RFA needle into the tumor, delivering energy to create thermal ablation, and assessing efficacy with contrast-enhanced imaging. The speaker notes the success rates and adverse events associated with RFA. They also mention a study suggesting that adding RFA to chemotherapy may improve survival in patients with unresectable pancreatic cancer. The speaker concludes that EUS-guided ablation therapy is effective in selected cases and calls for further standardized techniques and additional data on its efficacy.

Asset Subtitle

Nonthalee Pausawasdi, MD

Keywords

EUS-guided ablation therapy

pancreatic tumors

EOS-guided ethanol injection

radiofrequency ablation

neuroendocrine tumors