Histotripsy of the Proximal Ureter and Renal Pelvis: Evaluation of Urothelial Injury in a Porcine Survival Model.

Autor:	Kisting AL; University of Wisconsin-Madison Departments of Radiology, Los Angeles, CA., Zlevor AM; University of Wisconsin-Madison Departments of Radiology, Los Angeles, CA., Falk KL; University of Wisconsin-Madison Departments of Radiology, Los Angeles, CA; Biomedical Engineering, Los Angeles, CA., Kisting MA; University of Wisconsin-Madison Departments of Radiology, Los Angeles, CA., Laklouk IA; University of California, Los Angeles Department of Anatomic Pathology, Los Angeles, CA., Wagner MG; University of Wisconsin-Madison Departments of Radiology, Los Angeles, CA; Medical Physics, Los Angeles, CA., White JK; University of Wisconsin-Madison Departments of Radiology, Los Angeles, CA., Winterholler JE; University of Wisconsin-Madison Departments of Radiology, Los Angeles, CA., Jentink M; University of Wisconsin-Madison Departments of Radiology, Los Angeles, CA., Abel EJ; Urology, Los Angeles, CA., Knavel Koepsel EM; University of Wisconsin-Madison Departments of Radiology, Los Angeles, CA., Hinshaw JL; University of Wisconsin-Madison Departments of Radiology, Los Angeles, CA; Urology, Los Angeles, CA., Swietlik JF; University of Wisconsin-Madison Departments of Radiology, Los Angeles, CA., Mao L; Urology, and Biostatistics, Madison, WI., Minesinger GM; Medical Physics, Los Angeles, CA., Laeseke PF; University of Wisconsin-Madison Departments of Radiology, Los Angeles, CA; Biomedical Engineering, Los Angeles, CA., Ziemlewicz TJ; University of Wisconsin-Madison Departments of Radiology, Los Angeles, CA., Lee FT Jr; University of Wisconsin-Madison Departments of Radiology, Los Angeles, CA; Biomedical Engineering, Los Angeles, CA; Urology, Los Angeles, CA. Electronic address: ftlee@wisc.edu.
Jazyk:	angličtina
Zdroj:	Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2024 Dec 09. Date of Electronic Publication: 2024 Dec 09.
DOI:	10.1016/j.jvir.2024.11.028
Abstrakt:	Purpose: To evaluate the response of the ureter and renal pelvis to direct targeting by histotripsy guided by cone-beam CT (CBCT) in a human-scale porcine chronic-survival model. Methods: Bilateral ureteral histotripsy treatments were completed on 6 female swine (n=12). Animals were divided into two groups: Acute (n=2 animals, 4 treatments, sacrificed at Day 0) and Chronic (n=4 animals, 8 treatments, sacrificed at Day 7 (n=2) and Day 28 (n=2)). For each treatment, a 2.5 cm sphere (ureter/renal pelvis and renal parenchyma) was targeted using CBCT guidance. Computed tomography urography (CTU) imaging was performed immediately post-treatment for all animals, and on Days 7 and 28 for chronic animals, followed by sacrifice, necropsy, and histopathology. Serum chemistries were drawn pre-treatment, Day 7, and Day 28. Results: All 12 treatments were successful in targeting the renal pelvis/ureter and renal parenchyma. CTU findings at Day 0 included ureteral thickening (9/12), delayed parenchymal enhancement (3/12) and mild hydronephrosis (5/12), all resolving by Day 7. Histologic findings of low-grade damage resolved by Day 7. No urine leaks or ureteral strictures were observed. Renal function (Cr, eGFR) remained within the normal range throughout the study. Conclusions: Histotripsy treatment of the ureter and renal pelvis results in transient injuries, suggesting that treatment of central renal tumors adjacent to the ureter and renal pelvis may be safe. The results of this study could help expand the range of renal tumors that can be treated with histotripsy. (Copyright © 2024. Published by Elsevier Inc.)
Databáze:	MEDLINE
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