Removal of residual cavitation nuclei to enhance histotripsy erosion of model urinary stones


Histotripsy has been shown to be a good treatment for model kidney stones, eroding their surface to little particulate debris via a cavitational bubble cloud. But, kind of like shock wave lithotripsy, histotripsy stone treatments display a rate-dependent efficacy, with pulses applied at a coffee rate generating a lot of efficient stone erosion in comparison with those applied at a high rate. This is hypothesized to be the result of residual cavitation bubble nuclei generated by bubble cloud collapse. Although the histotripsy bubble cloud only lasts on the order of 100 ??s, these microscopic remnant bubbles can persist on the order of 1 s, inducing direct attenuation of subsequent histotripsy pulses and influencing bubble cloud dynamics. In an effort to mitigate these effects, we have a tendency to have developed a novel strategy to actively remove residual cavitation nuclei from the field using low-amplitude ultrasound pulses. Previous work has demonstrated that with selection of the suitable acoustic parameters these bubble removal pulses will stimulate the aggregation and subsequent coalescence of microscopic bubble nuclei, effectively deleting them from the target volume. Here, we have a tendency to incorporate bubble removal pulses in histotripsy treatment of model kidney stones. It was found that when histotripsy is applied at low rate (1 Hz), bubble removal will not turn out a statistically important amendment in erosion. At higher pulse rates of 10, one hundred, and five hundred Hz, incorporating bubble removal leads to, 7.5-, and 2.7-fold increases in stone erosion, respectively. High-speed imaging indicates that the introduction of bubble removal pulses permits bubble cloud dynamics resulting from high pulse rates to a lot of closely approximate those generated at the low rate of one Hz. These results corroborate previous work in the sector of shock wave lithotripsy relating to the ill effects of residual bubble nuclei, and recommend that prime treatment potency can be recovered at high pulse rates through appropr- ate manipulation of the cavitation setting surrounding the stone.

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