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 Exclusion Criteria: * For all patients * Known bleeding disorder that cannot be sufficiently corrected with co-fact or fresh frozen plasma (FFP) * Use of anticoagulants that cannot be discontinued * INR \>1.5 or platelet count \<50.000 * Previous inclusion in other studies * Pregnancy * Minimal distance from the main pancreatic duct \<1mm * Inability to si…