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Urinary stone erosion and fragmentation under low-intensity quasi-collimated ultrasound using gas-filled microbubbles with stone-targeting lipid shells

Pishchalnikov, Yuri A. and Behnke-Parks, William and Mellema, Matt and Hopcroft, Matt and Luong, Alice and Colonius, Tim and Maeda, Kazuki and Morrison, Kyle and Laser, Daniel (2018) Urinary stone erosion and fragmentation under low-intensity quasi-collimated ultrasound using gas-filled microbubbles with stone-targeting lipid shells. In: 175th Meeting of the Acoustical Society of America, 7–11 May 2018, Minneapolis, MN. https://resolver.caltech.edu/CaltechAUTHORS:20190709-092102360

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Abstract

Urinary stone lithotripsy critically depends on the presence of cavitation nuclei at the stone surface. We hypothesized that introduction of stone-targeting microbubbles could increase cavitation activity at a stone surface sufficiently to allow stone erosion and fragmentation at peak negative pressures much lower than in acoustic energy-based urinary stone interventions with induced cavitation nuclei alone. Gas-filled microbubbles were produced with calcium-binding moieties incorporated into an encapsulating lipid shell. Stone surface coverage with these targeting microbubbles was found to approach an optimal (considering microbubble expansion during insonation) range of 5–15% with incubation times of three minutes or less. Using high-speed photomicroscopy, we observe bound microbubbles expanding 10- to 30-fold under insonation with quasi-collimated sources at mechanical indexes below 1.9. For observed stand-off parameters in the range of 0.2–0.6, the modeled collapse-generated shockwaves exceed 100 MPa. In swine model studies with these targeting microbubbles, stone fragmentation into passable fragments occurs with treatment times around 30 minutes, while post-treatment examination of ureters and kidneys shows no evidence of urothelium damage or renal parenchymal hemorrhage. The stone-targeting microbubbles reported on here have formed the basis for a new non-invasive urinary stone treatment which recently entered human clinical trials.


Item Type:Conference or Workshop Item (Paper)
Related URLs:
URLURL TypeDescription
https://doi.org/10.1121/1.5036106DOIArticle
https://asa.scitation.org/doi/10.1121/1.5036106PublisherArticle
https://acousticalsociety.org/program-of-175th-meeting-of-the-acoustical-society-of-america/Related ItemConference Site
https://acousticalsociety.org/wp-content/uploads/2018/04/mondaytofriday.pdfRelated ItemConference Program
ORCID:
AuthorORCID
Colonius, Tim0000-0003-0326-3909
Maeda, Kazuki0000-0002-5729-6194
Additional Information:© 2018 Acoustical Society of America. Published Online: 17 April 2018.
Record Number:CaltechAUTHORS:20190709-092102360
Persistent URL:https://resolver.caltech.edu/CaltechAUTHORS:20190709-092102360
Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:96979
Collection:CaltechAUTHORS
Deposited By: Melissa Ray
Deposited On:11 Jul 2019 22:33
Last Modified:03 Oct 2019 21:27

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