Minimally invasive image-guided therapy of primary and metastatic pancreatic cancer

Figure 2 Intraoperative irreversible electroporation of a pancreatic adenocarcinoma. A: Pre-operative contrast-enhanced computed tomography image shows a hypodense mass in the head of the pancreas. A hyperdense fiducial marker, which was placed for prior radiation therapy, is also visible in the mass; B: Intraoperative ultrasound image shows 4 Í 3.2 cm hypoechoic mass in the pancreas; C: Intraoperative photo shows the patient with upper median laparotomy with ablation probes are placed directly into the pancreatic tumor, using ultrasound guidance; D: Follow-up imaging 1 mo after the irreversible electroporation (IRE) showed an avascular ablation zone covering the previously seen pancreatic tumor. The CA19-9 tumor marker decreased from 959 U/mL to 76 U/mL 1 mo after the ablation. The patient is still alive 31 mo after the IRE ablation.