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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. [ABSTRACT FROM AUTHOR]

Burst wave lithotripsy (BWL) is a potential noninvasive treatment for breaking kidney stones. BWL requirements of high-pressure output, limited aperture for acoustic window, and specific focal length and frequency constrain the focal beam width. However, BWL is most effective only on stones smaller than the beam width. We tested a porous piezoelectric material (PZ36) to increase the output power and designed acoustic lenses that broaden the beam. A weighted iterative angular spectrum approach was used to calculate the source phase distribution needed to generate desired cross sectional focal beam profiles each of 12 mm width. The phase calculations were then 3D printed as holographic lenses placed over a circular aperture of 80-mm diameter, 350 kHz PZ36 to produce the desired beam at 85 mm depth. The difference in simulated beam width and that measured by hydrophone was <1 mm, and the structural-similarity index value was greater than 0.65. The differences in structures were due not to shape and size of the 6-dB contours but to amplitude distribution within the contour. In conclusion, this design approach combined with 3D printing provides a way to tailor focal beam profiles for lithotripsy transducers. [ABSTRACT FROM AUTHOR]

In therapeutic applications of biomedical ultrasound, it is important to understand the behavior of cavitation bubbles. Herein, the dynamics of a single, spherical bubble in water are modeled using the Gilmore equation closed by an energy balance on bubble contents for calculation of pressures inside the bubble. Moreover, heat and mass transfer at the bubble wall are incorporated using the Eller-Flynn zeroth-order approximation for gas diffusion, an estimation of non-equilibrium phase change based on the kinetic theory of gases, and assumed shapes for the spatial temperature distribution in the surrounding liquid. Bubble oscillations predicted by this model are investigated in response to a lithotripter shock wave. Model results indicate that vapor trapped inside the bubble during collapse plays a significant role in the afterbounce behavior and is sensitively dependent upon the ambient liquid temperature. Initial experiments have been conducted to quantify the afterbounce behavior of a single bubble as a function of ambient temperature; however, the results imply that many bubbles are present and collectively determine the collapse characteristics. © 2006 American Institute of Physics [ABSTRACT FROM AUTHOR]

Lithotripter pulses (∼7–10 μs) initiate the growth of cavitation bubbles, which collapse hundreds of microseconds later. Since the bubble growth-collapse cycle trails passage of the pulse, and is ∼1000 times shorter than the pulse interval at clinically relevant firing rates, it is not expected that cavitation will affect pulse propagation. However, pressure measurements with a fiber-optic hydrophone (FOPH-500) indicate that bubbles generated by a pulse can, indeed, shield the propagation of the negative tail. Shielding was detected within 1 μs of arrival of the negative wave, contemporaneous with the first observation of expanding bubbles by high-speed camera. Reduced negative pressure was observed at 2 Hz compared to 0.5 Hz firing rate, and in water with a higher content of dissolved gas. We propose that shielding of the negative tail can be attributed to loss of acoustic energy into the expansion of cavitation bubbles. © 2006 American Institute of Physics [ABSTRACT FROM AUTHOR]

Mechanisms of stone fragmentation by lithotripter shock waves were studied. Numerically, an isotropic-medium, elastic-wave model was employed to isolate and assess the importance of individual mechanisms in stone comminution. Experimentally, cylindrical U-30 cement stones were treated in an HM-3-style research lithotripter. Baffles were used to block specific waves responsible for spallation, squeezing, or shear. Surface cracks were added to stones to simulate the effect of cavitation, and then tested in water and glycerol (a cavitation suppressive medium). The calculated location of maximum stress compared well with the experimental observations of where cracks naturally formed. Shear waves from the shock wave in the fluid traveling along the stone surface (a kind of dynamic squeezing) led to the largest stresses in the cylindrical stones and the fewest shock waves to fracture. Reflection of the longitudinal wave from the back of the stone — spallation — and bubble-jet impact on the proximal and distal faces of the stone produced lower stresses and required more shock waves to fracture stones, but cavitation stresses become comparable in small stone pieces. Surface cracks accelerated fragmentation when created near the location where the maximum stress was predicted. © 2006 American Institute of Physics [ABSTRACT FROM AUTHOR]

A multi-frame high-speed photography was used to investigate the dynamics of cavitation bubbles induced by a passage of a lithotripter shock wave in a water tank. Solitary bubbles in the free field each radiated a shock wave upon collapse, and typically emitted a micro-jet on the rebound following initial collapse. For bubbles in clouds, emitted jets were directed toward neighboring bubbles and could break the spherical symmetry of the neighboring bubbles before they in turn collapsed. Bubbles at the periphery of a cluster underwent collapse before the bubbles at the center. Observations with high-speed imaging confirm previous predictions that bubbles in a cavitation cloud do not cycle independently of one another but instead interact as a dynamic bubble cluster. © 2006 American Institute of Physics [ABSTRACT FROM AUTHOR]

The goal of this work was to compare measured and numerically predicted HIFU pressure waveforms in water and a tissue-mimicking phantom. Waveforms were measured at the focus of a 2-MHz HIFU transducer with a fiber optic hydrophone. The transducer was operated with acoustic powers ranging from 2W to 300W. A KZK-type equation was used for modeling the experimental conditions. Strongly asymmetric nonlinear waves with peak positive pressure up to 80 MPa and peak negative pressure up to 20 MPa were measured in water, while waves up to 50 MPa peak positive pressure and 15 MPa peak negative pressure were measured in tissue phantoms. The values of peak negative pressure corresponded well with numerical simulations and were significantly smaller than predicted by linear extrapolation from low-level measurements. The values of peak positive pressures differed only at high levels of excitation where bandwidth limitations of the hydrophone failed to fully capture the predicted sharp shock fronts. © 2006 American Institute of Physics [ABSTRACT FROM AUTHOR]

Although extracorporeal shock wave lithotripsy (a procedure of kidney stone comminution using focused shock waves) has been used clinically for many years, a proper monitoring of the stone fragmentation is still undeveloped. A method considered here is based on recording shock wave scattering signals with a focused receiver placed far from the stone, outside the patient body. When a fracture occurs in the stone or the stone becomes smaller, the elastic waves in the stone will propagate differently (e.g. shear waves will not cross a fracture) which, in turn, will change the scattered acoustic wave in the surrounding medium. Theoretical studies of the scattering phenomenon are based on a linear elastic model to predict shock wave scattering by a stone, with and without crack present in it. The elastic waves in the stone and the nearby liquid were modeled using a finite difference time domain approach. The subsequent acoustic propagation of the scattered waves into the far-field was calculated using the Helmholtz-Kirchhoff integral. Experimental studies were conducted using a research electrohydraulic lithotripter that produced the same acoustic output as an unmodified Dornier HM3 clinical lithotripter. Artificial stones, made from Ultracal-30 gypsum and acrylic, were used as targets. The stones had cylindrical shape and were positioned co-axially with the lithotripter axis. The scattered wave was measured by focused broadband PVDF hydrophone. It was shown that the size of the stone noticeably changed the signature of the reflected wave. © 2006 American Institute of Physics [ABSTRACT FROM AUTHOR]

Shock waves are now used to treat a variety of musculoskeletal indications and the worldwide demand for shock wave therapy (SWT) is growing rapidly. It is a concern that very little is known about the mechanisms of action of shock waves in SWT. The technology for SWT devices is little changed from that of shock wave lithotripters developed for the treatment of urinary stones. SWT devices are engineered on the same acoustics principles as lithotripters, but the targets of therapy for SWT and shock wave lithotripsy (SWL) are altogether different. For SWT to achieve its potential as a beneficial treatment modality it will be necessary to determine precisely how SWT shock waves interact with biological targets. In addition, for SWT to evolve, the future design of these devices should be approached with caution, and lithotripsy may serve as a useful model. Indeed, there is a great deal to be learned from the basic research that has guided the development of SWL. © 2006 American Institute of Physics [ABSTRACT FROM AUTHOR]

The coupling efficiency of a “dry head” electromagnetic lithotripter (Dornier Compact Delta) was studied in vitro. A fiber-optic probe hydrophone (FOPH-500) was positioned in a test tank filled with degassed water. The tank was coupled through a semi-transparent latex membrane to the water-filled cushion of the lithotripter head, so that bubbles (air pockets) trapped between the two coupling surfaces could be easily observed and photographed. When gel was applied to both the latex membrane and the water cushion, numerous bubbles (some several millimeters in diameter) could be seen at the coupling interface. Hydrophone measurements in the geometric focus of the lithotripter showed that the acoustic pressure could be two times lower when bubbles were present than when they were manually removed. In our in vitro design, trapped bubbles could be easily observed and therefore removed from the acoustic path. However, during patient treatment with a dry-head lithotripter one cannot see whether bubbles are trapped against the skin. This study provides a demonstration of the dramatic effect that trapped bubbles can have on the amount of acoustic energy actually delivered for treatment. © 2006 American Institute of Physics [ABSTRACT FROM AUTHOR]

Numerical simulations of focused acoustic beams are performed in water over a wide range of linear gains and source amplitudes, in order to demonstrate the combined effect of acoustic nonlinearity, diffraction, and focusing on extrapolation (derating) of the main parameters of high intensity acoustic fields at the focus from the linear theory. It is shown that nonlinear corrections to the focusing gain are different for different parameters of the acoustic field and for different values of the linear gain. Nonlinear enhancement of the focusing gain is found to be more pronounced for the peak positive pressure and for higher linear gains. The levels of nonlinear saturation for various parameters of the field at the focus are obtained for very high source amplitudes. The results of simulations give higher saturation levels compared to the approximate analytic predictions. © 2005 American Institute of Physics [ABSTRACT FROM AUTHOR]

Comminution of axisymmetric stones by a lithotripter shock wave was studied experimentally and theoretically. In experiments, shock waves were generated by a research electrohydraulic lithotripter modeled after the Dornier HM-3, and stones were made from U-30 cement. Cylindrical stones of various length to diameter ratios, stones of conical shape, and stones with artificial cracks were studied. In other cases, baffles to block specific waves that contribute to spallation or squeezing were used, and glycerol was used to suppress cavitation. The theory was based on the elasticity equations for an isotropic medium. The equations were written in finite differences and integrated numerically. Maximum compression, tensile and shear stresses were predicted depending on the stone shape and side-surface condition in order to investigate the importance of the stone geometry. It is shown that the theoretical model used explains the observed position of a crack in a stone. The theory also predicts the efficiency of stone fragmentation depending on its shape and size, as well as on the presence of cracks on the stone surface and baffles near the stone. © 2005 American Institute of Physics [ABSTRACT FROM AUTHOR]