Ultrasound intensity to propel stones from the kidney is below the threshold for renal injury

Yak Nam Wang, Julianna C. Simon, Bryan Cunitz, Frank Starr, Marla Paun, Denny Liggitt, Andrew Evan, James McAteer, James Williams, Ziyue Liu, Peter Kaczkowski, Ryan Hsi, Mathew Sorensen, Jonathan Harper, Michael R. Bailey

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Therapeutic ultrasound has an increasing number of applications in urology, including shockwave lithotripsy, stone propulsion, tissue ablation, and hemostasis. However, the threshold of renal injury using ultrasound is unknown. The goal of this study was to determine kidney injury thresholds for a range of intensities between diagnostic and ablative therapeutic ultrasound. A 2 MHz annular array generating spatial peak pulse average intensities (ISPPA) up to 28,000 W/cm2 in water was placed on the surface of in vivo porcine kidneys and focused on the adjacent parenchyma. Treatments consisted of pulses of 100 μs duration triggered every 3 ms for 10 minutes at various intensities. The perfusion-fixed tissue was scored by 3 blinded independent experts. Above a threshold of 16,620 W/cm2, the majority of injury observed included emulsification, necrosis and hemorrhage. Below this threshold, almost all injury presented as focal cell and tubular swelling and/or degeneration. These findings provide evidence for a wide range of potentially therapeutic ultrasound intensities that has a low probability of causing injury. While this study did not examine all combinations of treatment parameters of therapeutic ultrasound, tissue injury appears dose-dependent.

Original languageEnglish (US)
Title of host publicationProceedings of Meetings on Acoustics
Volume19
DOIs
StatePublished - 2013
Externally publishedYes
Event21st International Congress on Acoustics, ICA 2013 - 165th Meeting of the Acoustical Society of America - Montreal, QC, Canada
Duration: Jun 2 2013Jun 7 2013

Other

Other21st International Congress on Acoustics, ICA 2013 - 165th Meeting of the Acoustical Society of America
CountryCanada
CityMontreal, QC
Period6/2/136/7/13

Fingerprint

kidneys
rocks
thresholds
urology
hemostatics
hemorrhages
degeneration
necrosis
propulsion
pulses
swelling
ablation
dosage
cells
water

ASJC Scopus subject areas

  • Acoustics and Ultrasonics

Cite this

Wang, Y. N., Simon, J. C., Cunitz, B., Starr, F., Paun, M., Liggitt, D., ... Bailey, M. R. (2013). Ultrasound intensity to propel stones from the kidney is below the threshold for renal injury. In Proceedings of Meetings on Acoustics (Vol. 19). [075066] https://doi.org/10.1121/1.4800361

Ultrasound intensity to propel stones from the kidney is below the threshold for renal injury. / Wang, Yak Nam; Simon, Julianna C.; Cunitz, Bryan; Starr, Frank; Paun, Marla; Liggitt, Denny; Evan, Andrew; McAteer, James; Williams, James; Liu, Ziyue; Kaczkowski, Peter; Hsi, Ryan; Sorensen, Mathew; Harper, Jonathan; Bailey, Michael R.

Proceedings of Meetings on Acoustics. Vol. 19 2013. 075066.

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Wang, YN, Simon, JC, Cunitz, B, Starr, F, Paun, M, Liggitt, D, Evan, A, McAteer, J, Williams, J, Liu, Z, Kaczkowski, P, Hsi, R, Sorensen, M, Harper, J & Bailey, MR 2013, Ultrasound intensity to propel stones from the kidney is below the threshold for renal injury. in Proceedings of Meetings on Acoustics. vol. 19, 075066, 21st International Congress on Acoustics, ICA 2013 - 165th Meeting of the Acoustical Society of America, Montreal, QC, Canada, 6/2/13. https://doi.org/10.1121/1.4800361
Wang YN, Simon JC, Cunitz B, Starr F, Paun M, Liggitt D et al. Ultrasound intensity to propel stones from the kidney is below the threshold for renal injury. In Proceedings of Meetings on Acoustics. Vol. 19. 2013. 075066 https://doi.org/10.1121/1.4800361
Wang, Yak Nam ; Simon, Julianna C. ; Cunitz, Bryan ; Starr, Frank ; Paun, Marla ; Liggitt, Denny ; Evan, Andrew ; McAteer, James ; Williams, James ; Liu, Ziyue ; Kaczkowski, Peter ; Hsi, Ryan ; Sorensen, Mathew ; Harper, Jonathan ; Bailey, Michael R. / Ultrasound intensity to propel stones from the kidney is below the threshold for renal injury. Proceedings of Meetings on Acoustics. Vol. 19 2013.
@inproceedings{06840677a2294b7f82eaca6762c6f089,
title = "Ultrasound intensity to propel stones from the kidney is below the threshold for renal injury",
abstract = "Therapeutic ultrasound has an increasing number of applications in urology, including shockwave lithotripsy, stone propulsion, tissue ablation, and hemostasis. However, the threshold of renal injury using ultrasound is unknown. The goal of this study was to determine kidney injury thresholds for a range of intensities between diagnostic and ablative therapeutic ultrasound. A 2 MHz annular array generating spatial peak pulse average intensities (ISPPA) up to 28,000 W/cm2 in water was placed on the surface of in vivo porcine kidneys and focused on the adjacent parenchyma. Treatments consisted of pulses of 100 μs duration triggered every 3 ms for 10 minutes at various intensities. The perfusion-fixed tissue was scored by 3 blinded independent experts. Above a threshold of 16,620 W/cm2, the majority of injury observed included emulsification, necrosis and hemorrhage. Below this threshold, almost all injury presented as focal cell and tubular swelling and/or degeneration. These findings provide evidence for a wide range of potentially therapeutic ultrasound intensities that has a low probability of causing injury. While this study did not examine all combinations of treatment parameters of therapeutic ultrasound, tissue injury appears dose-dependent.",
author = "Wang, {Yak Nam} and Simon, {Julianna C.} and Bryan Cunitz and Frank Starr and Marla Paun and Denny Liggitt and Andrew Evan and James McAteer and James Williams and Ziyue Liu and Peter Kaczkowski and Ryan Hsi and Mathew Sorensen and Jonathan Harper and Bailey, {Michael R.}",
year = "2013",
doi = "10.1121/1.4800361",
language = "English (US)",
volume = "19",
booktitle = "Proceedings of Meetings on Acoustics",

}

TY - GEN

T1 - Ultrasound intensity to propel stones from the kidney is below the threshold for renal injury

AU - Wang, Yak Nam

AU - Simon, Julianna C.

AU - Cunitz, Bryan

AU - Starr, Frank

AU - Paun, Marla

AU - Liggitt, Denny

AU - Evan, Andrew

AU - McAteer, James

AU - Williams, James

AU - Liu, Ziyue

AU - Kaczkowski, Peter

AU - Hsi, Ryan

AU - Sorensen, Mathew

AU - Harper, Jonathan

AU - Bailey, Michael R.

PY - 2013

Y1 - 2013

N2 - Therapeutic ultrasound has an increasing number of applications in urology, including shockwave lithotripsy, stone propulsion, tissue ablation, and hemostasis. However, the threshold of renal injury using ultrasound is unknown. The goal of this study was to determine kidney injury thresholds for a range of intensities between diagnostic and ablative therapeutic ultrasound. A 2 MHz annular array generating spatial peak pulse average intensities (ISPPA) up to 28,000 W/cm2 in water was placed on the surface of in vivo porcine kidneys and focused on the adjacent parenchyma. Treatments consisted of pulses of 100 μs duration triggered every 3 ms for 10 minutes at various intensities. The perfusion-fixed tissue was scored by 3 blinded independent experts. Above a threshold of 16,620 W/cm2, the majority of injury observed included emulsification, necrosis and hemorrhage. Below this threshold, almost all injury presented as focal cell and tubular swelling and/or degeneration. These findings provide evidence for a wide range of potentially therapeutic ultrasound intensities that has a low probability of causing injury. While this study did not examine all combinations of treatment parameters of therapeutic ultrasound, tissue injury appears dose-dependent.

AB - Therapeutic ultrasound has an increasing number of applications in urology, including shockwave lithotripsy, stone propulsion, tissue ablation, and hemostasis. However, the threshold of renal injury using ultrasound is unknown. The goal of this study was to determine kidney injury thresholds for a range of intensities between diagnostic and ablative therapeutic ultrasound. A 2 MHz annular array generating spatial peak pulse average intensities (ISPPA) up to 28,000 W/cm2 in water was placed on the surface of in vivo porcine kidneys and focused on the adjacent parenchyma. Treatments consisted of pulses of 100 μs duration triggered every 3 ms for 10 minutes at various intensities. The perfusion-fixed tissue was scored by 3 blinded independent experts. Above a threshold of 16,620 W/cm2, the majority of injury observed included emulsification, necrosis and hemorrhage. Below this threshold, almost all injury presented as focal cell and tubular swelling and/or degeneration. These findings provide evidence for a wide range of potentially therapeutic ultrasound intensities that has a low probability of causing injury. While this study did not examine all combinations of treatment parameters of therapeutic ultrasound, tissue injury appears dose-dependent.

UR - http://www.scopus.com/inward/record.url?scp=84878983862&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84878983862&partnerID=8YFLogxK

U2 - 10.1121/1.4800361

DO - 10.1121/1.4800361

M3 - Conference contribution

VL - 19

BT - Proceedings of Meetings on Acoustics

ER -