SIR 2024
Interventional Oncology
Adrienne L. Kisting, BS
Research Assistant
University of Wisconsin
Financial relationships: Full list of relationships is listed on the CME information page.
Annie M. Zlevor (she/her/hers)
Medical Student
University of Wisconsin School of Medicine and Public Health
Financial relationships: Full list of relationships is listed on the CME information page.
Katrina L. Falk, MS (she/her/hers)
Graduate Research Fellow
University of Wisconsin Madison
Financial relationships: Full list of relationships is listed on the CME information page.
Meridith A. Kisting, MA (she/her/hers)
Research Assistant
University of Wisconsin Hospitals and Clinics
Financial relationships: Full list of relationships is listed on the CME information page.
Martin G. Wagner, PhD
Assistant Professor
University of Wisconsin Madison
Disclosure information not submitted.
Jim White, n/a
Laboratory Manager
University of Wisconsin - Madison
Disclosure information not submitted.
John E. Winterholler, MD (he/him/his)
Resident Physician, Interventional Radiology
UW Hospitals and Clinics
Disclosure information not submitted.
Madeline Jentink, DO, DO
Resident Physician
UW Hospitals and Clinics
Disclosure information not submitted.
Jason Abel, MD
Associate Professor
University of Wisconsin - Madison
Disclosure information not submitted.
Erica M. Knavel Koepsel, MD (she/her/hers)
Assistant Professor of Radiology
University of Wisconsin-Madison
Disclosure information not submitted.
Lindsay Stratchko, DO
Assistant Professor
University of Wisconsin-Madison
Disclosure information not submitted.
J. Louis Hinshaw, MD
Professor
University of Wisconsin School of Medicine and Public Health
Disclosure information not submitted.
John F. Swietlik, MD
Assistant Professor
University of Wisconsin
Disclosure information not submitted.
Lu Mao, PhD
Associate Professor
University of Wisconsin School of Medicine and Public Health
Disclosure information not submitted.
Grace M. Minesinger, BS (she/her/hers)
Graduate Research Assistant
University of Wisconsin Madison
Financial relationships: Full list of relationships is listed on the CME information page.
Ayca Z. Kutlu, MD (she/her/hers)
Honorary Research Fellow
University of Wisconsin Madison
Financial relationships: Full list of relationships is listed on the CME information page.
Paul F. Laeseke, MD, PhD
Assistant Professor
University of Wisconsin
Disclosure information not submitted.
Timothy J. Ziemlewicz, MD
Associate Professor of Radiology
University of Wisconsin Hospital and Clinics
Disclosure information not submitted.
Fred T. Lee, Jr., MD
Professor of Radiology, Biomedical Engineering, and Urology
University Of Wisconsin
Financial relationships: Full list of relationships is listed on the CME information page.
Histotripsy is a focused ultrasound technique that mechanically destroys target tissue and has previously proven safe when treating kidney tissue. This study primarily evaluates the ability of the ureter and renal pelvis to withstand direct histotripsy treatments in a human-scale porcine model with a secondary endpoint of targeting accuracy of cone beam computed tomography guidance (CBCT).
Materials and Methods: Bilateral ureteral histotripsy (Cloudbreak, Histosonics Inc.) was completed on 6 female swine. 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 encompassing the proximal ureter/renal pelvis and lower renal pole was selected on CBCT using ImFusion planning software. CT urography imaging was performed immediately post-treatment for all animals, and again on Days 7 and 28 for survival animals followed by sacrifice, necropsy, and histology
Results: All treatments were well tolerated with no changes in animal behavior or health. The integrated CBCT planning system was successful in treating the ureter/renal pelvis in all cases (12/12). CT findings immediately after treatment included: ureteral thickening (9/12), low-grade obstruction of the ureter (12/12), and mild hydronephrosis (5/12). All imaging findings of injury resolved by Day 7. No urine leaks or ureteral strictures were observed. The mean distance between the treated ureter and the nearest intestine was 1.8 ± 0.8 mm. Histologic findings of low-grade damage resolved by Day 7.
Conclusion: Targeted histotripsy treatment of the ureter and renal pelvis appears safe with transient injuries immediately post-treatment noted to resolve by Day 7. This suggests that future treatment of centrally located renal tumors adjacent to the ureter and renal pelvis with CBCT guidance is feasible.