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We first validated the feasibility and safety of endoscopic ultrasound (EUS)\u2010guided Yttrium\u201090 (<jats:sup>90<\/jats:sup>Y) microspheres implantation in a porcine model. Under EUS guidance, <jats:sup>90<\/jats:sup>Y\u2010loaded microspheres were implanted into the pancreas of 10 miniature pigs. The first pig was implanted with 10 MBq particles. Subsequently, nine pigs were sequentially included in the low\u2010 (20 MBq), medium\u2010 (40 MBq), and high\u2010dose (60 MBq) groups. Positron emission tomography (PET)\/CT imaging was used to check the occurrence of particle displacement postoperatively. After euthanasia, the pancreas and adjacent organs were excised for histological examination and residue radiation detection. The absorbed doses demonstrated safe in the porcine model were further in the xenograft model and <jats:italic>KRAS<jats:sup>LSL\/+<\/jats:sup>Trp53<jats:sup>FL\/FL<\/jats:sup>Ptfqa<jats:sup>Cre\/+<\/jats:sup><\/jats:italic> mouse model. EUS\u2010guided implantations of <jats:sup>90<\/jats:sup>Y\u2010loaded microspheres were successful in all animals. Two pigs had mild serum amylase elevation in the high\u2010dose group and the abnormal index returned to baseline without interventions. The volume of necrotic lesions ranged from 255.76 to 745.57\u00a0mm<jats:sup>3<\/jats:sup>. In KPC mouse model, PET\/CT imaging demonstrated a significant decrease in maximum standardized uptake value (SUVmax) after <jats:sup>90<\/jats:sup>Y implantation. EUS\u2010guided <jats:sup>90<\/jats:sup>Y\u2010loaded carbon microsphere implantation could serve as a safe and feasible technique at ultrahigh dose for pancreatic cancer brachytherapy.<\/jats:p>","DOI":"10.1002\/mco2.70117","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T06:41:32Z","timestamp":1740552092000},"source":"Crossref","is-referenced-by-count":3,"title":["Endoscopic Ultrasound\u2010Guided Brachytherapy of Yttrium\u201090 Implantation Into Pancreas: A Dose\u2010Escalation Pilot Study"],"prefix":"10.1002","volume":"6","author":[{"given":"Yuchong","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yilei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Tongji 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