A microbubble agent improves the therapeutic efficiency of high intensity focused ultrasound: a rabbit kidney study

Eighty kidneys (40 left and 40 right kidneys) of New Zealand rabbits were ablated using high intensity focused ultrasound (HIFU), (14,300 W/cm(2), 1.0 MHz). Kidneys were randomly divided into two groups. HIFU was performed in the manner of linear scan in both groups. Prior to HIFU, normal saline solution and isovolumetric microbubble agent were administrated intravenously in groups I and II, respectively. HIFU was finished in all left kidneys and in 26/40 right ones. The therapeutic efficiency was reflected using necrosis rate (cubic centimeters per second), which was the tissue volume of coagulative necrosis per 1 s HIFU exposure. In both groups, predetermined volumes were damaged without harming overlying tissues. Necrosis rates were increased in group II both in left (0.0089+/-0.0107 vs. 0.0493+/-0.0777, P=0.0323) and in right (0.0039+/-0.0055 vs. 0.0162+/-0.0168, P=0.0248) kidneys. Pathological examinations confirmed that there were no intact tissue focuses within exposed regions in either group. These findings suggested that the microbubble agent improved the therapeutic efficiency of HIFU. Hemorrhage and hyperemia were also detected on the margin of the ablated tissues (both in cortex and medulla) in both groups.