Factors Affecting Tissue Cavitation during Burst Wave Lithotripsy.

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From: Ultrasound in Medicine & Biology(Vol. 47, Issue 8)
Publisher: Elsevier B.V.
Document Type: Report; Brief article
Length: 296 words

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Key Words Shock wave lithotripsy; Renal injury; Burst wave lithotripsy; Nephrolithiasis Abstract Burst wave lithotripsy (BWL) is a technology under clinical investigation for non-invasive fragmentation of urinary stones. Under certain ranges of ultrasound exposure parameters, this technology can cause cavitation in tissue leading to renal injury. This study sought to measure the focal pressure amplitude needed to cause cavitation in vivo and determine its consistency in native tissue, in an implanted stone model and under different exposure parameters. The kidneys of eight pigs were exposed to transcutaneous BWL ultrasound pulses. In each kidney, two locations were targeted: the renal sinus and the kidney parenchyma. Each was exposed for 5 min at a set pressure level and parameters, and cavitation was detected using an active cavitation imaging method based on power Doppler ultrasound. The threshold was determined by incrementing the pressure amplitude up or down after each 5-min interval until cavitation occurred/subsided. The pressure thresholds were remeasured postsurgery, targeting an implanted stone or collecting space (in sham). The presence of a stone or sham surgery did not significantly impact the threshold for tissue cavitation. Targeting parenchyma instead of kidney collecting space and lowering the ultrasound pulse repetition frequency both resulted in an increased pressure threshold for cavitation. Author Affiliation: (*) Department of Urology, University of Washington School of Medicine, Seattle, Washington, USA ([Dagger]) Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA 1 Address correspondence to: Adam Maxwell, Department of Urology, University of Washington School of Medicine, 1013 NE 40th Street, Seattle WA 98105, USA. Article History: Received 2 December 2020; Revised 26 March 2021; Accepted 20 April 2021 Byline: Adam D. Maxwell [amax38@uw.edu] ([Dagger],1), Christopher Hunter ([Dagger]), Bryan W. Cunitz ([Dagger]), Wayne Kreider ([Dagger]), Stephanie Totten ([Dagger]), Yak-Nam Wang ([Dagger])

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Gale Document Number: GALE|A666501612