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Histotripsy of Subcutaneous Fat in a Live Porcine Model

  • Laboratory Investigation
  • Non-Vascular Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

This study was designed to evaluate the feasibility and safety of histotripsy subcutaneous (SQ) fat treatment in an in-vivo porcine model, and evaluate evolution of the treated volume on MRI and pathology.

Methods/Materials

10 histotripsy SQ fat treatments were completed in 5 swine, divided into four groups based on pre-determined survival: day 0 (n = 4), day 7 (n = 2), day 28 (n = 2), and day 56 (n = 2). A 4.0 × 4.0x2.0 cm ovoid treatment was created in the fat pad of the posterior thorax. MRI of survived animals were obtained on day 7 (n = 6), day 28 (n = 4), and day 56 (n = 2), and reviewed for size and imaging characteristics. Technical success was defined as the creation of a treatment zone in the targeted SQ fat. Skin firmness and indentation were qualitatively scored.

Results

Histotripsy had a 100% (10/10) technical success for creation of SQ fat treatments. Mean treatment time was 35.5 min (range 35–36.5). The volume of treated SQ fat demonstrated 92% volume reduction over the study. Day 0 gross pathology treatment had a mean volume of 12.6 cm3 (± 2.1) (prescribed volume of 16.7 cm3), which decreased to 8.3 cm3 (± 2.8) by day 7 (34% overall decrease), 3.0 cm3 (± 0.5) by day 28 (76% overall decrease), and 1.0 cm3 (± 1.2) by day 56 (92% overall decrease). Mean firmness and indentation scores showed no change from baseline at all time points, with no overlying skin injury.

Conclusion

Histotripsy safely and effectively treated SQ fat of an in-vivo porcine model, with volume reduction over time.

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References

  1. Hales CM. Prevalence of obesity among adults and youth: United States, 2015–2016. 2017;(288):8.

  2. Coelho M, Oliveira T, Fernandes R. Biochemistry of adipose tissue: an endocrine organ. Arch Med Sci AMS. 2013;9(2):191–200.

    Article  CAS  Google Scholar 

  3. Hotamisligil GS, Shargill NS, Spiegelman BM. Adipose expression of tumor necrosis factor-alpha: direct role in obesity-linked insulin resistance. Science. 1993;259(5091):87–91.

    Article  CAS  Google Scholar 

  4. The American Society for, Aesthetic Plastic Surgery. Cosmetic Surgery National Data Bank Statistics for 2017 [Internet]. The American Society for Aesthetic Plastic Surgery; 2017 [cited 2018 Nov 1]. Available from: https://www.surgery.org/sites/default/files/ASAPS-Stats2017.pdf

  5. Cao H, Long X, Zhang H, Xu L, Liu Z, Wang X. The efficacy and safety study of JCS-01 non-invasive focused ultrasound fat reduction machine. Zhongguo Yi Liao Qi Xie Za Zhi 2012;36(5):370–372, 381.

  6. Coleman W, Coleman W, Weiss R, Kenkel J, Ad-El D, Amir R. A multicenter controlled study to evaluate multiple treatments with nonthermal focused ultrasound for noninvasive fat reduction. Dermatol Surg. 2017;43(1):50–7.

    Article  CAS  Google Scholar 

  7. Gold MH, Patrick Coleman W, William Coleman I, Weiss R. A randomized, controlled multicenter study evaluating focused ultrasound treatment for fat reduction in the flanks. J Cosmet Laser Ther. 2019;21(1):44–8.

    Article  Google Scholar 

  8. Hong J, Ko E, Choi S, et al. Efficacy and safety of high-intensity focused ultrasound for noninvasive abdominal subcutaneous fat reduction. Dermatol Surg. 2020;46(2):213–9.

    Article  CAS  Google Scholar 

  9. Kwon T-R, Im S, Jang Y-J, et al. Improved methods for evaluating pre-clinical and histological effects of subcutaneous fat reduction using high-intensity focused ultrasound in a porcine model. Skin Res Technol. 2017;23(2):194–201.

    Article  Google Scholar 

  10. Lee HJ, Lee M-H, Lee SG, Yeo U-C, Chang SE. Evaluation of a novel device, high-intensity focused ultrasound with a contact cooling for subcutaneous fat reduction. Lasers Surg Med. 2016;48(9):878–86.

    Article  Google Scholar 

  11. Saedi N, Kaminer M. New waves for fat reduction: high-intensity focused ultrasound. Semin Cutan Med Surg. 2013;32(1):26–30.

    Google Scholar 

  12. Weinstein Velez M, Ibrahim O, Petrell K, Dover JS. Nonthermal pulsed ultrasound treatment for the reduction in abdominal fat. J Clin Aesthetic Dermatol. 2018;11(9):32–6.

    Google Scholar 

  13. Wilkerson EC, Bloom BS, Goldberg DJ. Clinical study to evaluate the performance of a noninvasive focused ultrasound device for thigh fat and circumference reduction compared to control. J Cosmet Dermatol. 2018;17(2):157–61.

    Article  Google Scholar 

  14. Zhou B, Leung BYK, Sun L. The Effects of Low-Intensity Ultrasound on Fat Reduction of Rat Model. BioMed Res Int [Internet] 2017 [cited 2020 Oct 23];2017. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587957/

  15. Alizadeh Z, Halabchi F, Mazaheri R, Abolhasani M, Tabesh M. Review of the Mechanisms and Effects of Noninvasive Body Contouring Devices on Cellulite and Subcutaneous Fat. Int J Endocrinol Metab [Internet] 2016 [cited 2020 Apr 15];14(4). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5236497/

  16. Kennedy J, Verne S, Griffith R, Falto-Aizpurua L, Nouri K. Non-invasive subcutaneous fat reduction: a review. J Eur Acad Dermatol Venereol. 2015;29(9):1679–88.

    Article  CAS  Google Scholar 

  17. Vlaisavljevich E, Maxwell A, Mancia L, Johnsen E, Cain C, Xu Z. Visualizing the histotripsy process: bubble cloud-cancer cell interactions in a tissue-mimicking environment. Ultrasound Med Biol. 2016;42(10):2466–77.

    Article  Google Scholar 

  18. Vlaisavljevich E, Kim Y, Owens G, Roberts W, Cain C, Xu Z. Effects of tissue mechanical properties on susceptibility to histotripsy-induced tissue damage. Phys Med Biol. 2014;59(2):253–70.

    Article  Google Scholar 

  19. Swietlik JF, Mauch SC, Knott EA, et al. Noninvasive thyroid histotripsy treatment: proof of concept study in a porcine model. Int J Hyperthermia Taylor & Francis; 2021;38(1):798–804.

  20. Knott EA, Swietlik JF, Longo KC, et al. Robotically-assisted sonic therapy for renal ablation in a live porcine model: initial preclinical results. J Vasc Interv Radiol JVIR. 2019;30(8):1293–302.

    Article  Google Scholar 

  21. Longo KC, Knott EA, Watson RF, et al. Robotically assisted sonic therapy (RAST) for noninvasive hepatic ablation in a porcine model: mitigation of body wall damage with a modified pulse sequence. Cardiovasc Intervent Radiol. 2019;42(7):1016–23.

    Article  Google Scholar 

  22. Smolock AR, Cristescu MM, Vlaisavljevich E, et al. Robotically Assisted Sonic Therapy as a Noninvasive Nonthermal Ablation Modality: Proof of Concept in a Porcine Liver Model. Radiology Radiological Society of North America; 2018;287(2):485–493.

  23. Kaoutzanis C, Gupta V, Winocour J, et al. Cosmetic liposuction: preoperative risk factors, major complication rates, and safety of combined procedures. Aesthet Surg J. 2017;37(6):680–94.

    Article  Google Scholar 

  24. Alderman A, Collins E, Streu R, et al. Benchmarking outcomes in plastic surgery: national complication rates for abdominoplasty and breast augmentation ‘outcomes article]. Plast Reconstr Surg. 2009;124(6):2127–33.

    Article  CAS  Google Scholar 

  25. Maxwell AD, Cain CA, Hall TL, Fowlkes JB, Xu Z. Probability of cavitation for single ultrasound pulses applied to tissues and tissue-mimicking materials. Ultrasound Med Biol. 2013;39(3):449–65.

    Article  Google Scholar 

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Acknowledgements

The authors gratefully acknowledge the contributions of Jon Cannata Ph.D., Alex Duryea Ph.D., Ryan Miller Ph.D., for engineering and technical support, and Allison Rodgers, Jen Frank, Keri Graff for assistance in animal handling and cares.

Funding

This study was partially funded by Histosonics, Inc.

Author information

Authors and Affiliations

  1. Department of Radiology, University of Wisconsin, 600 Highland Ave, Madison, WI, 53792, USA

    John F. Swietlik, Emily A. Knott, Katherine C. Longo, Annie M. Zlevor, Paul F. Laeseke, Scott B. Reeder, Fred T. Lee Jr & Timothy J. Ziemlewicz

  2. Department of Pathology, University of Wisconsin, 1685 Highland Ave, Madison, WI, 53705, USA

    Xiaofei Zhang

  3. Department of Medical Physics, University of Wisconsin, 1111 Highland Ave, Madison, WI, 53705, USA

    Scott B. Reeder

  4. Department of Biomedical Engineering, University of Wisconsin, 1550 Engineering Dr, Madison, WI, 53706, USA

    Scott B. Reeder

  5. Department of Medicine, University of Wisconsin, 1685 Highland Ave, Madison, WI, 53792, USA

    Scott B. Reeder

  6. Department of Emergency Medicine, University of Wisconsin, 800 University Bay Dr Suite 310, Madison, WI, 53705, USA

    Scott B. Reeder

  7. Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd, Ann Arbor, MI, 48109, USA

    Zhen Xu

  8. Department of Urology, The University of Wisconsin, 1685 Highland Ave, Madison, WI, 53705, USA

    Fred T. Lee Jr

Authors
  1. John F. Swietlik
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  2. Emily A. Knott
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  3. Katherine C. Longo
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  4. Annie M. Zlevor
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  7. Scott B. Reeder
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  8. Zhen Xu
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  9. Fred T. Lee Jr
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  10. Timothy J. Ziemlewicz
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Corresponding author

Correspondence to John F. Swietlik.

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Conflicts of interest

JS, EK, KL, AZ, XZ: None. PFL: Histosonics, Inc: stockholder and research support; Ethicon, Inc: paid consultant; Elucent Medical: paid consultant and stockholder; McGinley Orthopedic Innovations: stockholder; Siemens Medical: research support. SBR: Elucent Medical: stockholder; Reveal Pharmaceuticals: stockholder; Cellectar Biosciences: stockholder; HeartVista: stockholder. ZX: Histosonics, Inc: founder, stockholder, paid consultant, research support. FTL: Histosonics, Inc: Board of Directors, stockholder, research support; Medtronic Inc: patents, royalties; Ethicon, Inc: paid consultant. TZ: Histosonics, Inc: stockholder; Ethicon, Inc: paid consultant.

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For this type of study, consent for publication is not required.

Ethical Approval.

All applicable internation, national, and/or institutional guidelines for the care and use of animals were followed. All procedures performed in studies involving animals were in accordance with the ethical standards of the institution or practice at which the studies were conducted.

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Swietlik, J.F., Knott, E.A., Longo, K.C. et al. Histotripsy of Subcutaneous Fat in a Live Porcine Model. Cardiovasc Intervent Radiol 46, 120–127 (2023). https://doi.org/10.1007/s00270-022-03262-4

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  • DOI: https://doi.org/10.1007/s00270-022-03262-4

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