NanoKnife ablation, also known as irreversible electroporation (IRE), is a non-thermal ablation modality that induces tumor cell apoptosis by generating permanent nanoscale pores in the cell membrane via high-voltage, short-duration pulsed electric fields. By exploiting the differences in electrical properties between tissues, this technique precisely destroys tumor cells while preserving adjacent critical structures—such as blood vessels, bile ducts, and nerves—with minimal collateral damage. It effectively overcomes the key limitations of conventional thermal ablation, including the "heat-sink effect" and thermal injury to surrounding ductal and vessel walls.
Before treatment, a three-dimensional needle placement plan is developed based on imaging data. During the procedure, multiple electrode needles are precisely inserted around the lesion under CT or ultrasound guidance, and microsecond-duration electrical pulses are delivered according to a programmed protocol. Following treatment, the tumor cells undergo orderly apoptosis and are gradually absorbed by the body. The ablation margin remains well defined, and the function of surrounding organs is preserved to the greatest extent possible.
· Non-thermal mechanism that preserves critical ductal structures:selectively destroys tumor cell membranes while maintaining the integrity of the fibrous framework of blood vessels, bile ducts, pancreatic ducts, and other vital tubular structures.
· Sharp, well-defined margins with controllable treatment delivery: the ablation zone closely matches the electric field coverage, while real-time imaging guidance helps minimize the risk of collateral thermal injury to surrounding tissues.
· Apoptosis-driven mechanism with potential immune activation: tumor cell apoptosis can release tumor antigens, which may in turn stimulate the body's antitumor immune response.
It is primarily indicated for solid tumors located in anatomically complex regions adjacent to major blood vessels, bile ducts, pancreatic ducts, the intestines, or nerves—such as locally advanced pancreatic cancer, hilar hepatic tumors, renal hilar tumors, and prostate cancer. This technique offers a safe and effective option for curative or cytoreductive treatment in patients with unresectable lesions or tumors unsuitable for conventional thermal ablation.
