# BWL Interaction with Kidney Tissue

> **NIH NIH P01** · UNIVERSITY OF WASHINGTON · 2021 · $351,942

## Abstract

PROJECT SUMMARY/ABSTRACT - Project 3
Burst wave lithotripsy (BWL) is an emerging ultrasound-based technology that shows promise of being able to destroy
kidney stones in the setting of a physician’s office. Project 3 will be focusing its study of BWL on the interaction of the
BWL sound energy with actual human stones and with tissue. Our project is unique in its breadth of study of human
patients, animal models, ex vivo kidneys, and in vitro models, all supported by mathematical modeling. In Aim 1, we will
conduct in human observations of breaking stones with BWL and monitor BWL effects on renal tissue, testing the
hypothesis that BWL will break stones within the human kidney without significant damage to the kidney tissue. In this
Aim, Project 3 will collaborate with Project 1 to directly verify the breaking of stones by BWL within human kidneys, and
simultaneously study the visible effects of BWL on tissue, with and without the addition of adaptive feedback control
for cavitation. Visual documentation of stone breakage and tissue health will be done using state-of-the-art endoscopy
and stone analysis techniques. In Aim 2, we will assess experimentally and theoretically the effects of tissue calcification
on its interactions with BWL, testing the hypothesis that levels of calcification in tissue common to stone formers will
not result in increased damage by BWL. This aim will be accomplished using in vitro test systems in which human stone
material will be attached to or embedded within tissue-mimicking gels to model calcifications associated with renal
papillae, and the results quantitated using micro CT imaging. All of these experiments will be done hand-in-hand with
modeling by the Freund lab so that the overall results are more than simply empirical, but designed so that a deeper
understanding of the mechanisms of action of BWL sound energy in tissue of stone formers will be achieved. In Aim 3,
we will evaluate renal effects of BWL by measuring changes in kidney morphology and function associated with
transcutaneous BWL treatment in the living pig model, testing the hypothesis that the range of treatment parameters at
which BWL is both safe and highly effective can be extended using pre-treatment strategies that afford protection to
kidney tissue. The pig model will be used to measure effects of BWL on renal structure and function over a range of
energy doses above and below the threshold to induce ultrasound-visible cavitation linked to injury. The safety of
alternating application of BWL and UP will also be tested. Protection protocols that work with SW (e.g., pretreatment
with pause) will be tested for effect on renal response to BWL. In Aim 4, we will assess tissue health during BWL from
acoustic emissions and a biomechanical model of tissue damage in an ex vivo perfused kidney system, testing the
hypothesis that acoustic emissions from cavitation, coupled to a biomechanical tissue model can be used to monitor the
health of tissue during...

## Key facts

- **NIH application ID:** 10192513
- **Project number:** 5P01DK043881-27
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** JAMES CALDWELL WILLIAMS
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $351,942
- **Award type:** 5
- **Project period:** 1997-03-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10192513

## Citation

> US National Institutes of Health, RePORTER application 10192513, BWL Interaction with Kidney Tissue (5P01DK043881-27). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10192513. Licensed CC0.

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