Ann: Placement and Entitlement Offer to raise up to $7.1 million, page-61

There are a lot more interventional radiologist then EUS trained gastroenterologists, then convincing those EUS trained gastroenterologists to undertake the learning/certification of how to manage radioactive materials is going to be harder when they have enough business anyway unless they need a way to up their EUS numbers to maintain certification.

Cholecystostomy is pretty common and draining pancreatic pseudocysts doable as well but then would be a larger structure, so common to percutaneously implant things adjacent to the pancreas. Potentially you will only need some local anaesthetic and analgesia if you do this percutaneously as well although inital procedures are being done with GA then sedation. So pros and cons to everything, undoubtedly EUS is a more conventional way to image the area but the end of a long flexible probe is not exactly how I would want to deliver a radioactive particle that will make surrounding tissue necrotic.

Totally agree about the lack of evidence for efficacy but the absence of evidence is not evidence of absence and honestly why would high dose localised radiotherapy at the tumour site not help? It'd be why you were interested in the first place. Financially its a dog's breakfast and has to improve it's evidence base but the trial for sir-spheres was pretty small as well so wouldn't take much to get it over the line as there's not much else available