Physics of Shock‐Wave Lithotripsy

Cleveland, Robin O.; McAteer, James A.

doi:10.1002/9781444345148.ch49

Cited by 85 publications

(105 citation statements)

References 135 publications

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“…By varying the distance between the geometrically fixed pulse focus and the skin surface by gel pads of different thickness an adaption to individual soft-tissue conditions of patients can be achieved. Additionally, even thick layers of fat tissue can be overcome without significant attenuation or distortion of the frequency spectrum of the extracorporeal shockwave pulse [28].…”

Section: Discussionmentioning

confidence: 99%

Loosening detection of the femoral component of hip prostheses with extracorporeal shockwaves: A pilot study

Rieger

Jaeger

Kretzer

et al. 2015

Medical Engineering & Physics

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Section: Discussionmentioning

confidence: 99%

Loosening detection of the femoral component of hip prostheses with extracorporeal shockwaves: A pilot study

Rieger

Jaeger

Kretzer

et al. 2015

Medical Engineering & Physics

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“…21 The body wall occupies most of this path and because it includes muscle and fat it exhibits greater acoustic absorption than visceral organs such as the kidney. 22 Indeed, the kidney has little effect on SWs as shown by Cleveland and colleagues 15 who compared measures taken with a PVDF membrane hydrophone implanted on the anterior surface versus posterior surface of the kidney in vivo. Of the tissue types along the acoustic path, muscle exhibits the greatest acoustic absorption at the higher frequencies associated with a shock front.…”

Section: Discussionmentioning

confidence: 99%

Effect of the Body Wall on Lithotripter Shock Waves

McAteer

Williams

et al. 2014

Journal of Endourology

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Purpose: Determine the influence of passage through the body wall on the properties of lithotripter shock waves (SWs) and the characteristics of the acoustic field of an electromagnetic lithotripter. Methods: Full-thickness ex vivo segments of pig abdominal wall were secured against the acoustic window of a test tank coupled to the lithotripter. A fiber-optic probe hydrophone was used to measure SW pressures, determine shock rise time, and map the acoustic field in the focal plane. Results: Peak positive pressure on axis was attenuated roughly proportional to tissue thickness-approximately 6% per cm. Irregularities in the tissue path affected the symmetry of SW focusing, shifting the maximum peak positive pressure laterally by as much as *2 mm. Within the time resolution of the hydrophone (7-15 ns), shock rise time was unchanged, measuring *17-21 ns with and without tissue present. Mapping of the field showed no effect of the body wall on focal width, regardless of thickness of the body wall. Conclusions: Passage through the body wall has minimal effect on the characteristics of lithotripter SWs. Other than reducing pulse amplitude and having the potential to affect the symmetry of the focused wave, the body wall has little influence on the acoustic field. These findings help to validate laboratory assessment of lithotripter acoustic field and suggest that the properties of SWs in the body are much the same as have been measured in vitro.

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“…The pressure amplitudes and dimensions of the focal zone are dependent on numerous factors such as the focusing mechanism and the power setting at which the SWs are fired. 1 It is also true that measures of focal width are affected by the type of hydrophone used, and this may account in part for differences in values reported for a given lithotripter. By convention, the focal width is the diameter of the zone (focal zone) spanning the acoustic axis, where the positive pressure is at least half the maximum pressure.…”

Section: Discussionmentioning

confidence: 99%

“…For the most part, the properties of the SWs produced by different lithotripters, regardless of the type of SW generator used (i.e., electrohydraulic, electromagnetic, piezoelectric), are fundamentally the same. 1,2 What distinguishes one lithotripter from the next is its acoustic output, which is described primarily by the magnitude of the acoustic pressures produced and the dimensions of the focal zone.…”

mentioning

confidence: 99%

Evaluation of the LithoGold LG-380 Lithotripter:In VitroAcoustic Characterization and Assessment of Renal Injury in the Pig Model

Pishchalnikov

McAteer

Williams

et al. 2013

Journal of Endourology

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Purpose: Conduct a laboratory evaluation of a novel low-pressure, broad focal zone electrohydraulic lithotripter . Methods: Mapping of the acoustic field of the LG-380, along with a Dornier HM3, a Storz Modulith SLX, and a XiXin CS2012 (XX-ES) lithotripter was performed using a fiberoptic hydrophone. A pig model was used to assess renal response to 3000 shockwaves (SW) administered by a multistep power ramping protocol at 60 SW/min, and when animals were treated at the maximum power setting at 120 SW/min. Injury to the kidney was assessed by quantitation of lesion size and routine measures of renal function. Results: SW amplitudes for the LG-380 ranged from (P + /P -) 7/-1.8 MPa at PL-1 to 21/-4 MPa at PL-11 while focal width measured *20 mm, wider than the HM3 (8 mm), SLX (2.6 mm), or XX-ES (18 mm). For the LG-380, there was gradual narrowing of the focal width to *10 mm after 5000 SWs, but this had negligible effect on breakage of model stones, because stones positioned at the periphery of the focal volume (10 mm off-axis) broke nearly as well as stones at the target point. Kidney injury measured less than 0.1% FRV (functional renal volume) for pigs treated using a gradual power ramping protocol at 60 SW/min and when SWs were delivered at maximum power at 120 SW/min. Conclusions: The LG-380 exhibits the acoustic characteristics of a low-pressure, wide focal zone lithotripter and has the broadest focal width of any lithotripter yet reported. Although there was a gradual narrowing of focal width as the electrode aged, the efficiency of stone breakage was not affected. Because injury to the kidney was minimal when treatment followed either the recommended slow SW-rate multistep ramping protocol or when all SWs were delivered at fast SW-rate using maximum power, this appears to be a relatively safe lithotripter.

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Physics of Shock‐Wave Lithotripsy

Cited by 85 publications

References 135 publications

Loosening detection of the femoral component of hip prostheses with extracorporeal shockwaves: A pilot study

Loosening detection of the femoral component of hip prostheses with extracorporeal shockwaves: A pilot study

Effect of the Body Wall on Lithotripter Shock Waves

Evaluation of the LithoGold LG-380 Lithotripter:In VitroAcoustic Characterization and Assessment of Renal Injury in the Pig Model

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