Endoscopic Ultrasound-guided RadioFrequency Ablation for the Treatment Pancreatic NeuroEndocrine Neoplasms

Inclusion Criteria

• •For all patients
• •Age ≥18 years and \<80 years
• •Signed written informed consent
• •Distance from the main pancreatic duct ≥2mm
• •Able to undergo endoscopic ultrasound examination
• •Homogeneous enhancement at contrast harmonic EUS (CH-EUS)
• •For patients with functional pancreatic neuroendocrine neoplasms (F-PanNENs), almost all insulinomas
• •Definitive diagnosis of a clinical syndrome related to excessive insulin secretion fasting test, insulin blood levels, C-peptide blood levels)
• •Single lesion visualized at CT, and/or MRI, and/or EUS
• •Size \< 20mm
• •For patients with non functional pancreatic neuroendocrine neoplasms (NF-PanNENs)
• •EUS fine needle biopsy (FNB) proven NF-PanNENs
• •68Ga-DOTATATE PET/CT positive for a pancreatic lesion and negative for lymph nodes, liver, and other distant metastases
• •Hyper- or Iso-enhancing pattern at MRI and/or CT with negative lymph nodes, liver, and other distant metastases
• •G1 or G2 ≤ 5% on histological examination of EUS-guided biopsy samples utilizing EUS-FNB needles
• •Diameter between 15mm and 25mm,
• •Absence of symptoms
• •Absence of inner calcifications