Skip to main content
NCBI home page
NIHPA Author Manuscripts logoLink to NIHPA Author Manuscripts
. Author manuscript; available in PMC: 2020 Mar 6.
Published in final edited form as: Proc Meet Acoust. 2018 Nov 5;35(1):002001. doi: 10.1121/2.0000948

Summary of “Biomedical Acoustics and Physical Acoustics: Shock Waves and Ultrasound for Calculus Fragmentation”

Julianna C Simon 1, Michael R Bailey 2
PMCID: PMC7059322  NIHMSID: NIHMS1560074  PMID: 32148645

Abstract

This paper summarizes the special session, “Shock Waves and Ultrasound for Calculus Fragmentation,” that took place during the 176th Meeting of the Acoustical Society of America and 2018 Acoustics Week in Canada. The sessions were cosponsored by the Biomedical Acoustics and Physical Acoustics Technical Committees and consisted of ten talks by industry and academic researchers from institutions in the United States, France, and the Russian Federation. The sessions described basic and applied acoustic research to manage urinary stones.

1. SESSION OVERVIEW

Fundamental and applied acoustic research for managing urinary stones focuses many of the disciplines within the Biomedical and Physical Acoustics technical committees on a specific medical application. As such our session was similar to the session “The state of the art in lung ultrasound, past, present and future” held a day earlier in the meeting and coupled with, and benefited from, the discipline sessions “Therapeutic ultrasound transducers” and “Bubble Trouble in Therapeutic Ultrasound” between which it took place.

Kidney stones currently affect 1 in 11 Americans over their lifetime, and the prevalence is rising.1 Acoustics is essential in imaging, fragmenting, and passing stones. Shock wave lithotripsy (SWL) in which focused shock waves pass through the skin to fragment stones is by far the most established therapeutic ultrasound technology in medicine at almost 40 years old.

In those years, the ASA has played a major role in research and improvement of SWL with members producing too many papers to list all. For example, JASA published the first modeling paper on SWL cavitation in 1989,2 and the latest paper this month.3 JASA articles were the first to describe elastic waves within the stone4,5 and techniques to measure the stresses,6 both of which were found in presentations7,8 in this session. Similarly, JASA publications describe the general process of how stones break9.10, and Acoustics Today articles in 200311 and this year12 describe acoustic management of stones more broadly.

In reviewing the papers submitted,7,8,13–20 this session was the first in which every paper was directed to making new instruments to manage (particularly fragment) urinary stones. Although the fundamental science and advancement of scientific understanding remain, it is a shift that ASA researchers are now directly affecting the instruments used to treat patients or at least working in a direct line toward that goal. In addition, the instruments and techniques described in our session describe a paradigm shift (or several) in how stones are managed; these are not incremental changes to clinical procedures or commercial devices but entirely new approaches.

2. SUMMARY

The first seven presentations,7,8,13–17 in the session are products of a single large NIH grant focused on one vision for the noninvasive surgical management of stones: an office-based, handheld ultrasound device to target, detach, break, and expel stones and stone fragments from the urinary space to facilitate natural clearance. The talks by authors of different expertise summarized the ongoing efforts to address the many different technical challenges of such an ambitious undertaking as well as described the significant progress toward its clinical implementation. In the eighth presentation, Tamaddoni and Hall described an understanding and technique to control cavitation in order to deliver energy more effectively.18 Their work is directly applicable to the office-based device described above as well as SWL21 and is used in histrotripsy for fragmentation of tissue.22 In the ninth presentation, Thomas et al. described new acoustic sources and superposition of beams to make a new device with a broader focus to better fragment stones.19 This paper extended and applied an understanding gained from work published in JASA7 and elsewhere that beams broader than the stone diameter are more effective.24 In the final presentation, Pishchalinikov et al. used devices very similar to those in other presentations7,8,14–17 and focused on designing microbubbles to inject into the urinary space and attach to the stone to promote cavitation and stone fragmentation.20 Several previous JASA papers, many by authors in this session, discussed erosion of stone surfaces by cavitation6,7 and shielding of acoustic energy by bubbles between the source and the stone.24

3. CONCLUSION

Proceedings papers from the session follow this article in this issue of the Proceedings of Meetings on Acoustics (POMA). The titles of the ten presentations in the session are listed below and where currently available, a clickable link to the corresponding POMA paper is provided.

  1. Update on clinical trials results of kidney stone repositioning and preclinical results of stone breaking with one ultrasound system.13

  2. Acoustic radiation force acting on a spherical scatterer in water. Measurement and simulation.14 See related POMA paper.

  3. Generation of guided waves during burst wave lithotripsy as a mechanism of stone fracture.7

  4. Impact of stone characteristics on cavitation in burst wave lithotripsy.15

  5. Modeling and numerical simulation of the bubble cloud dynamics in an ultrasound field for burst wave lithotripsy.8

  6. Burst Wave Lithotripsy: An in vivo demonstration of efficacy and acute safety using a porcine model.16

  7. Design of a transducer for fragmenting large kidney stones using burst wave lithotripsy.17

  8. Acoustic bubble coalescence and dispersion for enhanced shock wave lithotripsy.18

  9. Confocal lens focused piezoelectric lithotripter.19

  10. Experimental observations and numerical modeling of lipid-shelled microbubbles with stone targeting moieties for minimally-invasive treatment of urinary stones.20

ACKNOWLEDGMENTS

We acknowledge funding support from NIH through NIDDK P01-DK043881.

Contributor Information

Julianna C. Simon, Graduate Program in Acoustics, Pennsylvania State University, Penn State 201E Applied Sciences Building, University Park, Pennsylvania, 16802

Michael R. Bailey, Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 40th St., Seattle, Washington, 98105

REFERENCES

  • 1.Scales CD Jr., Smith AC, Hanley JM, and Saigal CS (2012). Prevalence of kidney stones in the United States. European Urology 0(1), 160–165. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Church CC. A theoretical study of cavitation generated by an extracorporeal shock wave lithotripter The Journal of the Acoustical Society of America 86, 215 (1989); [DOI] [PubMed] [Google Scholar]
  • 3.Maeda K, Colonius T, Maxwell AD, Kreider W and Bailey MR, “Energy shielding of kidney stones by cavitation bubble clouds in Burst Wave Lithotripsy”, J Acosut Soc Am 2018. 144 2952–2961. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4.Dahake G and Gracewski SM, “Related articles finite difference predictions of P-SV wave propagation inside submerged solids. I. Liquid-solid interface conditions,” J. Acoust. Soc. Am 102, 2125–2137 1997. [DOI] [PubMed] [Google Scholar]
  • 5.Dahake G and Gracewski SM, “Finite difference predictions of P-SV wave propagation inside submerged solids. II. Effect of geometry,” J. Acoust. Soc. Am 102, 2138–2145 1997. [DOI] [PubMed] [Google Scholar]
  • 6.Xi X and Zhong P, “Dynamic photoelastic study of the transient stress field in solids during shock wave lithotripsy,” J. Acoust. Soc. Am 109, 1226–1239 2001. [DOI] [PubMed] [Google Scholar]
  • 7.Maxwell Adam D., MacConaghy Brian, Bailey Michael R., and Sapozhnikov Oleg A. Generation of guided waves during burst wave lithotripsy as a mechanism of stone fracture. J Acoust Soc Am. 2018. 144:3(pt. 2) 1779. [Google Scholar]
  • 8.Maeda K, Colonius T, Maxwell AD, Kreider W, Bailey MR, Modeling and numerical simulation of the bubble cloud dynamics in an ultrasound field for burst wave lithotripsy. J Acoust Soc Am. 2018. 144:3(pt. 2) 1780 and Proc. Mtgs. Acoust. 35, 020006 (2018); 10.1121/2.0000946. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9.Zhu S, Cocks FH, Preminger GM, Zhong P. The role of stress waves and cavitation in stone comminution in shock wave lithotripsy. Ultrasound Med Biol. 2002. May;28(5):661–71. [DOI] [PubMed] [Google Scholar]
  • 10.Sapozhnikov OA, Maxwell AD, MacConaghy B, and Bailey MR, “A mechanistic analysis of stone fracture in lithotripsy,” J. Acoust. Soc. Am 112(2) 1190–1202 (2007). [DOI] [PubMed] [Google Scholar]
  • 11.Simon JC, Maxwell AD, Bailey MR, Some work on the diagnosis and management of kidney stones with ultrasound, Acoustics Today 2017. [PMC free article] [PubMed] [Google Scholar]
  • 12.Bailey MR, McAteer JA, Pishchalnikov YA, Hamilton MF, and Colonius T, “Progress in lithotripsy research,” Acoustics Today 2006;3 18–29. [Google Scholar]
  • 13.Bailey MR, Wang YN, Kreider W, Dai JC, Cunitz BW, Harper JD, Chang H, Sorensen MD, Liu Z, Levy O, Dunmire B, Maxwell AD, Update on clinical trials results of kidney stone repositioning and preclinical results of stone breaking with one ultrasound system J Acoust Soc Am. 2018. 144:3(pt. 2) and Proc. Mtgs. Acoust. 35, 020004 (2018); 10.1121/2.0000949 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14.Karzova MM, Nikolaeva AV, Tsysar S, Khokhlova VA, Sapozhnikov OA, Acoustic radiation force acting on a spherical scatterer in water. Measurement and simulation. J Acoust Soc Am. 2018. 144:3(pt. 2) 1779. [Google Scholar]
  • 15.Hunter C, Cunitz B, Dunmire B, Bailey M, Randad A, Kreider W Maxwell AD, Sorensen MD, Williams JC, Impact of stone characteristics on cavitation in burst wave lithotripsy. J Acoust Soc Am. 2018. 144:3(pt. 2) 1779 and Proc. Mtgs. Acoust. 35, 020005 (2018); 10.1121/2.0000950 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 16.Wang YN, Kreider W, Hunter C, Cunitz B, Thiel J, Starr F, Dai J, Nazari Y, Lee D, Williams JC, Bailey M, A Maxwell Burst Wave Lithotripsy: An in vivo demonstration of efficacy and acute safety using a porcine model. J Acoust Soc Am. 2018. 144:3(pt. 2) 1780 and Proc. Mtgs. Acoust. 35, 020009 (2018); 10.1121/2.0000975. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17.Randad A, Ghanem MA, Bailey MR, Maxwell AD, Design of a transducer for fragmenting large kidney stones using burst wave lithotripsy, J Acoust Soc Am. 2018. 144:3(pt. 2) 1780 and Proc. Mtgs. Acoust. 35, 020007 (2018); 10.1121/2.0000954 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 18.Tamaddoni HA, Hall TL, Acoustic bubble coalescence and dispersion for enhanced shock wave lithotripsy. J Acoust Soc Am. 2018. 144:3(pt. 2) 1780. [Google Scholar]
  • 19.Thomas G, Chapelon JY, Birer A, Lafon C Confocal lens focused piezoelectric lithotripter, J Acoust Soc Am. 2018. 144:3(pt. 2) 1780–1781. [DOI] [PubMed] [Google Scholar]
  • 20.Pishchalnikov YA, Behnke-Parks W, Maeda K et al. Experimental observations and numerical modeling of lipid-shelled microbubbles with stone targeting moieties for minimally-invasive treatment of urinary stones, J Acoust Soc Am. 2018. 144:3(pt. 2) 1781 and Proc. Mtgs. Acoust. 35, 020008 (2018); 10.1121/2.0000958 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 21.Duryea AP, Roberts WW, Cain CA, Tamaddoni HA, and Hall TL (2014). Acoustic bubble removal to enhance SWL efficacy at high shock rate: An in vitro study. Journal of Endourology 28(1), 90–95. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 22.Wang TY1, Xu Z, Hall T, Fowlkes J, Roberts W, Cain C. Active focal zone sharpening for high-precision treatment using histotripsy. IEEE Trans Ultrason Ferroelectr Freq Control. 2011. February;58(2):305–15. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 23.Eisenmenger W (2001). The mechanisms of stone fragmentation in ESWL. Ultrasound in Medicine and Biology 27(5), 683–693. [DOI] [PubMed] [Google Scholar]
  • 24.Pishchalnikov YA, Williams JC, McAteer JA. Bubble proliferation in the cavitation field of a shock wave lithotripter. J Acoust Soc Am 2011;130:EL87–EL93 [DOI] [PMC free article] [PubMed] [Google Scholar]

RESOURCES