Focused ultrasound to displace renal calculi

Threshold for tissue injury

Yak Nam Wang, Julianna C. Simon, Bryan W. Cunitz, Frank L. Starr, Marla Paun, Denny H. Liggitt, Andrew Evan, James A. McAteer, Ziyue Liu, Barbrina Dunmire, Michael R. Bailey

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: The global prevalence and incidence of renal calculi is reported to be increasing. Of the patients that undergo surgical intervention, nearly half experience symptomatic complications associated with stone fragments that are not passed and require follow-up surgical intervention. In a clinical simulation using a clinical prototype, ultrasonic propulsion was proven effective at repositioning kidney stones in pigs. The use of ultrasound to reposition smaller stones or stone fragments to a location that facilitates spontaneous clearance could therefore improve stone-free rates. The goal of this study was to determine an injury threshold under which stones could be safely repositioned.Methods: Kidneys of 28 domestic swine were treated with exposures that ranged in duty cycle from 0%-100% and spatial peak pulse average intensities up to 30 kW/cm2 for a total duration of 10 min. The kidneys were processed for morphological analysis and evaluated for injury by experts blinded to the exposure conditions.Results: At a duty cycle of 3.3%, a spatial peak intensity threshold of 16,620 W/cm2 was needed before a statistically significant portion of the samples showed injury. This is nearly seven times the 2,400-W/cm2 maximum output of the clinical prototype used to move the stones effectively in pigs.Conclusions: The data obtained from this study show that exposure of kidneys to ultrasonic propulsion for displacing renal calculi is well below the threshold for tissue injury.

Original languageEnglish (US)
Article number5
JournalJournal of Therapeutic Ultrasound
Volume2
Issue number1
DOIs
StatePublished - Mar 31 2014

Fingerprint

Kidney Calculi
Swine
Wounds and Injuries
Kidney
Ultrasonics
Incidence

Keywords

  • Injury threshold
  • Kidney stones
  • Ultrasonic propulsion

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Wang, Y. N., Simon, J. C., Cunitz, B. W., Starr, F. L., Paun, M., Liggitt, D. H., ... Bailey, M. R. (2014). Focused ultrasound to displace renal calculi: Threshold for tissue injury. Journal of Therapeutic Ultrasound, 2(1), [5]. https://doi.org/10.1186/2050-5736-2-5

Focused ultrasound to displace renal calculi : Threshold for tissue injury. / Wang, Yak Nam; Simon, Julianna C.; Cunitz, Bryan W.; Starr, Frank L.; Paun, Marla; Liggitt, Denny H.; Evan, Andrew; McAteer, James A.; Liu, Ziyue; Dunmire, Barbrina; Bailey, Michael R.

In: Journal of Therapeutic Ultrasound, Vol. 2, No. 1, 5, 31.03.2014.

Research output: Contribution to journalArticle

Wang, YN, Simon, JC, Cunitz, BW, Starr, FL, Paun, M, Liggitt, DH, Evan, A, McAteer, JA, Liu, Z, Dunmire, B & Bailey, MR 2014, 'Focused ultrasound to displace renal calculi: Threshold for tissue injury', Journal of Therapeutic Ultrasound, vol. 2, no. 1, 5. https://doi.org/10.1186/2050-5736-2-5
Wang, Yak Nam ; Simon, Julianna C. ; Cunitz, Bryan W. ; Starr, Frank L. ; Paun, Marla ; Liggitt, Denny H. ; Evan, Andrew ; McAteer, James A. ; Liu, Ziyue ; Dunmire, Barbrina ; Bailey, Michael R. / Focused ultrasound to displace renal calculi : Threshold for tissue injury. In: Journal of Therapeutic Ultrasound. 2014 ; Vol. 2, No. 1.
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