Histotripsy of the prostate: dose effects in a chronic canine model.
Histotripsy of the prostate: dose effects in a chronic canine model.
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DOI：
10.1016/j.urology.2009.03.049
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发表时间：
2009-10
期刊：
影响因子：
2.1
通讯作者：
Roberts, William W.
中科院分区：
文献类型：
--
作者：
Hall, Timothy L.;Hempel, Christopher R.;Wojno, Kirk;Xu, Zhen;Cain, Charles A.;Roberts, William W.
本工作旨在发展组织切片超声治疗技术作为良性前列腺增生（BPH）的非侵入性治疗方法。我们之前已经在犬模型中证明了前列腺组织切片的可行性。本文的目的是研究组织学剂量-组织反应效应随时间的变化，为治疗优化提供见解。对20只犬的前列腺进行了不同剂量的经腹组织切片。然后在0到28天的间隔时间点收集治疗后的前列腺，并评估组织学治疗反应。研究发现，最低剂量只会产生分散的细胞破坏和坏死，而较高剂量会产生更显著的组织效应区域，导致组织充分分离，从而使物质可以随尿液排出。尿道组织比实质组织对较低剂量的组织免疫更强。以最低剂量治疗尿道似乎愈合，并有最小的长期后遗症。在给予足够剂量的情况下，组织切片法对前列腺实质组织和尿道组织的分割是有效的。这项技术的进一步发展可能会导致一种非侵入性的方法来减少前列腺的体积，以减轻与前列腺增生有关的症状。
This work aims to develop the technique of histotripsy ultrasound therapy as a non-invasive treatment for benign prostatic hyperplasia (BPH). We have previously demonstrated the feasibility of prostate histotripsy fractionation in a canine model. The purpose of this paper is to examine the histotripsy dose - tissue response effect over time to provide insight for treatment optimization. Various doses of histotripsy were applied trans-abdominally to the prostates of 20 canine subjects. Treated prostates were then harvested at interval time points from zero to 28 days and assessed for histologic treatment response. The lowest dose applied was found to produce only scattered cellular disruption and necrosis while higher doses produced more significant regions of tissue effect that resulted in sufficient fractionation of tissue so that the material could be voided with urination. Urethral tissue was more resistant to the lower histotripsy doses than was parenchymal tissue. Treatment of the urethra at the lowest doses appeared to heal with minimal long term sequelae. Histotripsy was effective at fractionating parenchymal and urethral tissue in the prostate given a sufficient dose. Further development of this technique could lead to a non-invasive method for debulking the prostate to relieve symptoms associated with BPH.
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