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• W1996996820 abstract "No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jun 2002High Intensity Focused Ultrasound as Noninvasive Therapy for Multilocal Renal Cell Carcinoma: Case Study and Review of The Literature KAI UWE KÖHRMANN, MAURICE STEPHAN MICHEL, JOCHEN GAA, ERNST MARLINGHAUS, and PETER ALKEN KAI UWE KÖHRMANNKAI UWE KÖHRMANN More articles by this author , MAURICE STEPHAN MICHELMAURICE STEPHAN MICHEL More articles by this author , JOCHEN GAAJOCHEN GAA More articles by this author , ERNST MARLINGHAUSERNST MARLINGHAUS More articles by this author , and PETER ALKENPETER ALKEN More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64992-0AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Noninvasive tumor ablation can be achieved by extracorporeally induced high intensity focused ultrasound. Clinical high intensity focused ultrasound performed to date for renal tumors have only been experimental in nature. We present specific details on a patient with renal cell carcinoma who underwent high intensity focused ultrasound with curative intent and long-term followup examinations. Materials and Methods: Ultrasound waves were generated by a cylindrical piezoelectric element focused by a paraboloid reflector. High intensity focused ultrasound was applied to 3 tumors in 3 sessions with the patient under general anesthesia or sedation analgesia, followed by magnetic resonance imaging for 6 months. Results: After treatment magnetic resonance imaging showed necrosis in the 2 tumors in the lower kidney pole within 17 and 48 days, respectively. The necrotic tumor area shrank thereafter within 6 months. The tumor in the upper pole was not affected by treatment due to absorption of the ultrasound energy by the interposed ribs. General anesthesia was required to apply high energy levels of focused ultrasound. Absorption of high intensity focused ultrasound in the tissue induced sharply demarcated thermonecrosis. For 50 years patients have been treated with high intensity focused ultrasound for different indications, focusing on the brain, eyes, prostate, liver and bladder. For the kidney experimental but only few clinical studies indicate sufficient tissue ablation. Conclusions: In our case contactless noninvasive application of high intensity focused ultrasound to 2 renal carcinomas achieved thermal ablation. When high intensity focused ultrasound energy was coupled correctly, no lesions occurred outside of the target area. Successful high intensity focused ultrasound application depended on optimum energy coupling, a sufficiently high ultrasound energy level and general anesthesia. References 1 : Nephron sparing surgery for renal tumors: indications, techniques and outcomes. J Urol2001; 166: 6. 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Google Scholar From the Department of Urology and Institute of Clinical Radiology, University Hospital Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany, and Storz Medical AG, Kreuzlingen, Switzerland© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited ByRoberts W, Hall T, Ives K, Wolf J, Fowlkes J and Cain C (2018) Pulsed Cavitational Ultrasound: A Noninvasive Technology for Controlled Tissue Ablation (Histotripsy) in the Rabbit KidneyJournal of Urology, VOL. 175, NO. 2, (734-738), Online publication date: 1-Feb-2006.MABJEESH N, AVIDOR Y and MATZKIN H (2018) Emerging Nephron Sparing Treatments for Kidney Tumors: A Continuum of Modalities From Energy Ablation to Laparoscopic Partial NephrectomyJournal of Urology, VOL. 171, NO. 2, (553-560), Online publication date: 1-Feb-2004.PATERSON R, BARRET E, SIQUEIRA T, GARDNER T, TAVAKKOLI J, RAO V, SANGHVI N, CHENG L and SHALHAV A (2018) Laparoscopic Partial Kidney Ablation With High Intensity Focused UltrasoundJournal of Urology, VOL. 169, NO. 1, (347-351), Online publication date: 1-Jan-2003. Volume 167Issue 6June 2002Page: 2397-2403 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordssurgical procedures, minimally invasivekidneyultrasonographyultrasonic therapycarcinoma, renal cellMetricsAuthor Information KAI UWE KÖHRMANN More articles by this author MAURICE STEPHAN MICHEL More articles by this author JOCHEN GAA More articles by this author ERNST MARLINGHAUS More articles by this author PETER ALKEN More articles by this author Expand All Advertisement PDF DownloadLoading ..." @default.
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