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A passive acoustic monitor of treatment effectiveness during extracorporeal lithotripsy

Record type: Article

Although extracorporeal shockwave lithotripsy (ESWL) has now been in the clinic for at least three decades, there has been little advance in efforts (i) to estimate the efficacy of the treatment whilst it is in progress, or (ii) to determine the end-point of a treatment session in terms of the degree of stone fragmentation achieved. Previous in vitro experimentation and clinical trials have shown that a passive acoustic monitor has the potential to provide evidence of the effectiveness and end-point of lithotripsy. The system exploits secondary emissions generated during shock-tissue interaction, whose features depend on the quality of tissue at the beam focus. This prototype was developed into the first commercially available clinical ESWL treatment monitor (Precision Acoustic Ltd, Dorchester, UK), and a unit has been acquired and tested in the clinical routine by urologists at Guy's and St Thomas NHS Trust in March 2009. This paper critically assesses the performance of the new system for the first 25 treatments monitored. The ESWL monitor correctly predicted the treatment outcome of 15 of the 18 treatments that were followed-up clinically. In addition, it was noted that the measure of treatment effectiveness provided by the monitor after 500 shocks was predictive of the final treatment outcome (p < 0.001). This suggests that the system could be used in pre-assessment; indicating if the stone is susceptible to ESWL or if the patient should be sent for surgery

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Citation

Fedele, F., Thomas, K, Leighton, T.G., Ryves, S., Phillips, D. and Coleman, A.J. (2011) A passive acoustic monitor of treatment effectiveness during extracorporeal lithotripsy Journal of Physics: Conference Series, 279, (1), 012021-[7pp]. (doi:10.1088/1742-6596/279/1/012021).

More information

Published date: 2011
Additional Information: Advanced Metrology for Ultrasound in Medicine (AMUM 2010) National Physical Laboratory, Teddington, UK, 12–14 May 2010

Identifiers

Local EPrints ID: 188325
URI: http://eprints.soton.ac.uk/id/eprint/188325
ISSN: 1742-6588
PURE UUID: 6a4a467a-dc6f-497e-baf3-a7f252e38dcf
ORCID for T.G. Leighton: ORCID iD orcid.org/0000-0002-1649-8750

Catalogue record

Date deposited: 25 May 2011 07:25
Last modified: 18 Jul 2017 11:42

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Contributors

Author: F. Fedele
Author: K Thomas
Author: T.G. Leighton ORCID iD
Author: S. Ryves
Author: D. Phillips
Author: A.J. Coleman

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