Thermal ablation of pancreatic cyst with a prototype endoscopic ultrasound capable radiofrequency needle device: A pilot feasibility study

Maria Moris, Mustafa Atar, Abdurrahman Kadayifci, Murli Krishna, Ariston Librero, Eugene Richie, William Brugge, Michael B. Wallace

Research output: Contribution to journalArticle

3 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)123-130
Number of pages8
JournalEndoscopic Ultrasound
Volume6
Issue number2
DOIs
StatePublished - Mar 1 2017

Fingerprint

Pancreatic Cyst
Feasibility Studies
Needles
Cysts
Hot Temperature
Equipment and Supplies
Temperature
Pancreatectomy
Fine Needle Biopsy
Small Intestine
Electrodes
Swine
Morbidity
Costs and Cost Analysis
Mortality

Keywords

  • Ablation
  • Cyst
  • Needle
  • Pancreas
  • Prototype

ASJC Scopus subject areas

  • Hepatology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Thermal ablation of pancreatic cyst with a prototype endoscopic ultrasound capable radiofrequency needle device : A pilot feasibility study. / Moris, Maria; Atar, Mustafa; Kadayifci, Abdurrahman; Krishna, Murli; Librero, Ariston; Richie, Eugene; Brugge, William; Wallace, Michael B.

In: Endoscopic Ultrasound, Vol. 6, No. 2, 01.03.2017, p. 123-130.

Research output: Contribution to journalArticle

Moris, M, Atar, M, Kadayifci, A, Krishna, M, Librero, A, Richie, E, Brugge, W & Wallace, MB 2017, 'Thermal ablation of pancreatic cyst with a prototype endoscopic ultrasound capable radiofrequency needle device: A pilot feasibility study', Endoscopic Ultrasound, vol. 6, no. 2, pp. 123-130. https://doi.org/10.4103/eus.eus_6_17
Moris, Maria ; Atar, Mustafa ; Kadayifci, Abdurrahman ; Krishna, Murli ; Librero, Ariston ; Richie, Eugene ; Brugge, William ; Wallace, Michael B. / Thermal ablation of pancreatic cyst with a prototype endoscopic ultrasound capable radiofrequency needle device : A pilot feasibility study. In: Endoscopic Ultrasound. 2017 ; Vol. 6, No. 2. pp. 123-130.
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AB - 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.

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