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Interventional oncology has become an essential component of the multidisciplinary team approach to cancer care. Using minimally invasive techniques, in combination with image guidance, interventional oncologists working at Miami Cancer Institute and Miami Cardiac & Vascular Institute are precisely targeting cancerous tumors using tools like NanoKnife. Learn how this procedure uses electricity to kill cancer cells from Govindarajan Narayanan, M.D. and Ripal Gandhi, M.D. and see the technology in action.
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[Baptist Health logo]
[Govindarajan Narayanan, M.D. Chief of Interventional Oncology Miami Cancer Institute]
[Dr. Narayanan]: The NanoKnife procedure is an ablation technology that uses the principle of irreversible electroporation. In short, it is harnessing the power of electricity to kill tumors.
[View through window into an interventional surgical suite at Miami Cardiac & Vascular Institute]
[Dr. Narayanan and Dr. Gandhi look at a scan of the patient's liver on a monitor outside the surgical suite. Both men are wearing scrubs]
The areas where this technology has been used mostly both in the United States and around the world is in liver, both primary and secondary and it has other niche applications.
[Ripal T. Gandhi, M.D. Interventional Radiologist Miami Cancer Institute]
[Dr. Gandhi]: So this is a patient who has colorectal cancer, metastatic disease to the liver. The patient had removal of the right side of the liver.
[PET scan of the patient's liver with the tumor appearing as a round, bright yellow area]
[Dr. Gandhi and the surgical team prepare instruments for the surgery in the surgical suite]
[Dr. Gandhi]:There's still one residual tumor left in the left side of the liver. This tumor happens to be adjacent to a vein, a big vein so today what we're doing is we're performing NanoKnife of this residual tumor with the hope that we can cure this patient of their disease.
[Dr. Narayanan]: When we perform these procedures with imaging guidance, predominantly use CAT scan guidance.
[Sedated patient is on the table, which is positioned partially inside a large CT scanner, as doctors perform the procedure. A doctor inserts the end of a long needle into the patient's skin in the abdominal area. Doctors check the needle's position in the CT display above the patient.]
[Dr. Narayanan]: You make about two to three millimeter incisions on the patient's skin and you place needles very precisely using imaging guidance. And once the needles are all in place, you do a what we call a 3D reconstruction.
[Animated simulation inside the body showing how needles are positioned surrounding the tumor]
[Dr. Narayanan]:We see the whole image in 3D and typically you need at least two needles to perform a treatment, so you need a positive and a negative and you need 70 pulses to be delivered between the two needles to complete a treatment.
[Before and after scans of the liver show that the tumor has shrunk after the treatment]
[Dr. Narayanan]: You do a final scan, make sure everything is okay. You'll be able to see the difference almost immediately after the treatment. Most of the times they are in-house just for one night, just for observation and they typically go home the very next morning.
[Dr. Gandhi]: I think it's, you know, an impressive technology. It's not used for everybody but for the right patient, it can be extremely helpful.
[Dr. Narayanan]: One main area of my personal interest where I've been working on for the last nine years, is the role of NanoKnife in pancreas.
[Dr. Gandhi]: Patients who have locally advanced pancreatic cancer, a lot of these patients have very limited other options, so this is where NanoKnife can be very helpful.
[Close up shot of the Nanoknife device]
[Wide shot through glass windows into the interventional radiology surgical suite with a procedure in progress.]
[Dr. Gandhi]: NanoKnife really gives us now the full complement of interventional oncology therapeutic procedures. So this is one of few centers in the entire country where we pretty much have every single modality available to treat patients with cancer from an interventional oncology perspective.
(music fades out)
[end of transcript]
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