We have some experience with the NanoKnife at UM, and I have been watching carefully for any experience from other centers. It is an ablative technique, similar to radiofrequency ablation (RFA) or microwave ablation. It's reported advantage is that it does less damage to surrounding normal structures (bile ducts, blood vessels), thus potentially allowing us to treat centrally located liver tumors, or tumors in the bile duct outside the liver, that are hard to treat with RFA.
Early experience suggests that it is safe and relatively easy to use either in the OR or percutaneously (through the skin) using ultrasound guidance. However the early recurrence rate in limited studies is a bit discouraging. More work is needed to figure out how to best use this therapy. However, given its relative safety it may allow us to treat some tumors we have not been treating well to date.
How it compares to radioembolization or chemoembolization is not clear. My personal opinion is that radioembolization has the most encouraging response rates of the liver-directed therapies.
Happy to discuss further. Feel free to email me any questions.