Development of a new diagnostic device for extracorporeal shock-wave lithotripsy

Extracorporeal Shock-Wave Lithotripsy (ESWL) is the leading technique for the non-invasive treatment of urinary stones. Thousands of ultrasound shocks are focused on the stones in order to break them into fragments small enough to be passed naturally by the body. The procedure is well established, though the re-treatment rate is around 50%. One of the limits of the procedure is that there is no capability for on-line monitoring of the degree of fragmentation of the stone. The output of the treatments could probably be improved if this facility was made available. The underlying physical mechanisms responsible for the break-up of the stone are still subject to investigation. However both direct stress damage and indirect cavitation erosion seem to be necessary to obtain eliminable fragments. In previous studies, Coleman et al. monitored cavitation in-vivo through the associated acoustic emissions. The objective of this research was to design a new diagnostic device for lithotripsy, exploiting the information carried by these acoustic emissions. After preliminary laboratory experiments some clinical prototypes were developed in collaboration with Precision Acoustic Ltd., UK. The prototypes are currently been tested in the clinic