Endoscopic Ultrasound (EUS) Guided Radiofrequency Ablation (RFA) for Pancreatic Neuroendocrine Tumors (PNET): are the Results Still Good when Based On Pet-Ct Ga68 Follow Up?

J Schifter; A Dancour; G Sheykman; M Benhaim; V Doviner; ML Dan; E Goldin

doi:10.1055/s-0041-1724298

Endoscopy, Table of Contents

Endoscopy 2021; 53(S 01): S18-S19
DOI: 10.1055/s-0041-1724298

Abstracts | ESGE Days

ESGE Days 2021 Oral presentations

Thursday, 25 March 2021 15:00 – 15:45 Therapeutic EUS: What are the new frontiers? Room 5

Endoscopic Ultrasound (EUS) Guided Radiofrequency Ablation (RFA) for Pancreatic Neuroendocrine Tumors (PNET): are the Results Still Good when Based On Pet-Ct Ga68 Follow Up?

Authors

J Schifter

¹Shaare Tzedek Medical Center, Digestive Diseases, Jerusalem, Israel
A Dancour

²Shaare Zedek Medical Center, Digestive Diseases Institute, Jerusalem, Israel
G Sheykman

²Shaare Zedek Medical Center, Digestive Diseases Institute, Jerusalem, Israel
M Benhaim

²Shaare Zedek Medical Center, Digestive Diseases Institute, Jerusalem, Israel
V Doviner

³Shaare Zedek Medical Center, Pathology, Jerusalem, Israel
ML Dan

²Shaare Zedek Medical Center, Digestive Diseases Institute, Jerusalem, Israel
E Goldin

²Shaare Zedek Medical Center, Digestive Diseases Institute, Jerusalem, Israel

Abstract

Full Text

Aims Preliminary results of EUS guided RFA ablation for pNET are promising. Since surgical specimens are not available, and CT, MRI or contrast EUS may lack sensitivity to detect remnant tumor tissue, success overestimation might have occurred. We aimed to evaluate the use of PET-CTga68 in such indication, in pretreatment positive cases.

Methods Prospective series of pNET patients with positive PET-CTga68 performed before and after EUS guided RFA ablation.

Results Ten pNET patients (2 with insulinoma) were included, Median age was 57 (24-80), median lesion size 18mm (7-25), locations were head (n = 4), body (n = 4) and tail (n = 2), 4 were close to the pancreatic duct (PD) and 5 to blood vessels. Median number of ablations was 7 (3-16). Negativization of PET-CTga68 uptake was achieved after a single RFA session in 4 patients and after 2 RFA sessions in another 4. In the 2 remaining patients negativization was not achieved after the first RFA session, one performed a second RFA session and is waiting for a follow-up PET-CTga68, the last patient requested surgical treatment. Two complications were documented: stenosis of the PD treated by transient stenting and one pseudo-aneurysm of the splenic artery managed angiographically. Median follow up was 25 months (5-34).

Conclusions Follow up PET-CTga68 in pretreatment positive patients helped to demonstrate 80 % of complete tumor ablation in this study. To reach such result 2 RFA sessions were often necessary without significant increase in adverse events. Longer and larger studies are still needed to confirm these results, particularly important to rule out the occurrence of distant metastasis.

Citation: Schifter J, Dancour A, Sheykman G et al. OP38 ENDOSCOPIC ULTRASOUND (EUS) GUIDED RADIOFREQUENCY ABLATION (RFA) FOR PANCREATIC NEUROENDOCRINE TUMORS (PNET): ARE THE RESULTS STILL GOOD WHEN BASED ON PET-CT GA68 FOLLOW UP?. Endoscopy 2021; 53: S18.