Rhode Island Hospital first in US to treat kidney tumor with new device using electrical pulses

January 09, 2009

PROVIDENCE, RI - On Thursday, January 8, Rhode Island Hospital treated an inoperable kidney tumor using a new technology known as NanoKnife. Damian Dupuy, MD, director of ablation services at Rhode Island Hospital and a national pioneer in ablation treatment, performed the procedure -- the first time it has been used on a kidney tumor in the United States.

NanoKnife is an image-guided device that uses "irreversible electroporation (IRE) technology" -- pulses of electricity that selectively destroy tumor cells while sparing nearby nerves, blood vessels and other delicate structures within the body. While considered a form of ablation, it uses electricity rather than heat like other ablation techniques such as cryo-ablation, radiofrequency and microwave ablation.

The Food and Drug Administration has approved the device for general soft tissue ablation. It was first used in Australia for tumors in the lungs and lymph nodes, and has been used in a handful of other types of cases in the United States.

Dupuy, who is serving as an advisor on the IRE technology, used the new NanoKnife on a 70-year-old female with a kidney tumor. The patient is reported to be doing well. Dupuy says, "I'm excited about the continued advances in ablation technology that broaden the applications for patients with cancer. These new technologies are revolutionizing the way we are able to treat cancer, allowing us to minimize collateral damage to surrounding tissue while maximizing tumor kill."

The NanoKnife is performed under sedation, however, little to no post-operative pain has been associated with the treatment to date. Because it is minimally invasive, Dupuy also notes that the new technology offers additional treatment options to patients who have no other alternatives or who have not responded to other forms of cancer treatment.

Prior forms of ablation treatment have been very successful in treating tumors in the past, and continue to provide new avenues of treatment for patients. Cryoablation, radiofrequency (RFA) and microwave ablation (MWA) all use intense heat or cold that destroys cells. The destroyed material may actually stay in the body for some time. The electrical fields used in the new IRE cause defects in cell membranes. Those cells within the targeted tissue then die within six hours of treatment, while the critical structures surrounding the targeted site are preserved and can then assist the body in removing the dead cells.

Damian Dupuy, MD, is a pioneer in image-guided ablation for the treatment of solid tumors, including RFA, MWA, cryoablation and now IRE. First approved by the FDA in 1997, RFA is a minimally invasive technique that uses heat to destroy tissue. A number of hospitals around the country have adopted the technique, most often to destroy liver tumors.

Dupuy, who is also a professor of diagnostic imaging at the Warren Alpert Medical School of Brown University, has broadened the applications of image-guided ablative therapies to successfully combat lung, kidney, adrenal, thyroid and bone cancer. Since 1997 more than 2,000 patients have undergone image-guided ablation at Rhode Island Hospital, the largest use of this technique in treating malignancy in North America. Other newer techniques such as combination therapies of ablation and external beam radiation or internal radiation seeds have been pioneered by Dupuy at Rhode Island Hospital. He is now leading National Cancer Institute-funded trials in the use of ablation for the treatment of tumors, and has published over 150 publications and given over 90 invited presentations nationally and internationally in the field of imaging and minimally invasive cancer therapies.
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Founded in 1863, Rhode Island Hospital (www.rhodeislandhospital.org) in Providence, RI, is a private, not-for-profit hospital and is the largest teaching hospital of The Warren Alpert Medical School of Brown University. A major trauma center for southeastern New England, the hospital is dedicated to being on the cutting edge of medicine and research. Many of its physicians are recognized as leaders in their respective fields of cancer, cardiology, diabetes, emergency medicine and trauma, neuroscience, orthopedics, pediatrics, radiation oncology and surgery. Rhode Island Hospital ranks among the country's leading independent hospitals that receive funding from the National Institutes of Health (NIH), with NIH research awards of nearly $27 million annually and nearly $46 million in total. It is home to Hasbro Children's Hospital, the state's only facility dedicated to pediatric care. Rhode Island Hospital is a founding member of the Lifespan health system.

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