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

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)).

A target containing phantom for accuracy assessment of cone-beam CT-guided histotripsy.

Purpose: Histotripsy is a nonionizing, noninvasive, and nonthermal focal tumor therapy. Cone-beam computed tomography (CBCT) guidance was developed for targeting tumors not visible on ultrasound. This approach assumes cavitation is formed at the geometrical focal point of the therapy transducer.

Interleaved x-ray imaging: A method for simultaneous acquisition of quantitative and diagnostic digital subtraction angiography.

Background: Flow altering angiographic procedures suffer from ill-defined, qualitative endpoints. Quantitative digital subtraction angiography (qDSA) is an emerging technology that aims to address this issue by providing intra-procedural blood velocity measurements from time-resolved, 2D angiograms. To date, qDSA has used 30 frame/s DSA imaging, which is associated with high radiation dose rate compared to clinical diagnostic DSA (up to 4 frame/s).

A Multimodal Phantom for Visualization and Assessment of Histotripsy Treatments on Ultrasound and X-Ray Imaging.

Objective: Histotripsy is an emerging non-invasive, non-ionizing and non-thermal focal tumor therapy. Although histotripsy targeting is currently based on ultrasound (US), other imaging modalities such as cone-beam computed tomography (CBCT) have recently been proposed to enable the treatment of tumors not visible on ultrasound. The objective of this study was to develop and evaluate a multi-modality phantom to facilitate the assessment of histotripsy treatment zones on both US and CBCT imaging.