Radiofrequency ablation of locally advanced pancreatic adenocarcinoma: An overview

Figure 1 Radiofrequency ablation procedure. Ultrasound-guided radiofrequency ablation performed during laparotomy in open surgery.

Figure 2 Intraoperative ultrasound monitoring. A: Needle with expandable electrodes is opened in the pancreatic hypoechoic mass under intraoperative ultrasound guidance; B: During radiofrequency ablation, the ablation zone becomes hyperechoic.

Figure 3 Needle with expandable electrodes. The electrodes can be opened into the lesion from the top (A) or from the back (B) of the needle.

Figure 4 Needle with single electrode. Single electrode of the needle in the lesion.

Figure 5 Pancreatic ductal adenocarcinoma after radiotherapy. A: Longitudinal color Doppler scan of the lesion, with hypoechoic infiltration of the superior mesenteric artery; B: Longitudinal contrast-enhanced ultrasonography scan of the hypovascular lesion.

Figure 6 Pancreatic ductal adenocarcinoma before and after radiofrequency ablation. A: Axial contrast-enhanced ultrasonography (US) scan of the hypovascular lesion; B: Axial contrast-enhanced US scan of the avascular lesion after radiofrequency ablation.

Figure 7 Pancreatic ductal adenocarcinoma before and after radiofrequency ablation. A: Contrast-enhanced computed tomography (CT) of pancreatic head lesion that appears hypodense and vascularized at perfusion CT (right side); B: Contrast-enhanced CT of the lesion after radiofrequency ablation, which appears hypodense and avascular at perfusion CT (right side).

Figure 8 Ablation zone on target lesion. A: Necrotic ablation zone (dotted grey) must covered the hepatocellular carcinoma (white); B: Necrotic ablation zone (dotted grey) must be included in the pancreatic ductal adenocarcinoma (grey).