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A passive acoustic monitor of treatment effectiveness during extracorporeal lithotripsy

Abstract

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  More>>
Authors:
Fedele, F; Coleman, A J; [1]  Thomas, K; Ryves, S; Phillips, D; [2]  Leighton, T G, E-mail: fiammetta.fedele@gstt.nhs.uk [3] 
  1. Medical Physics Department, Guy's and St Thomas NHS Foundation Trust, Westminster Bridge Road, SE1 7EH, London (United Kingdom)
  2. Urology Department, Guy's and St Thomas NHS Foundation Trust, Great Maze Pond, SE1 9RT, London (United Kingdom)
  3. Institute of Sound and Vibration Research, University of Southampton, Highfield, S017 1BJ, Southampton (United Kingdom)
Publication Date:
Feb 01, 2011
Product Type:
Journal Article
Resource Relation:
Journal Name: Journal of Physics. Conference Series (Online); Journal Volume: 279; Journal Issue: 1; Conference: AMUM 2010: 2. international conference on advanced metrology for ultrasound in medicine, Teddington (United Kingdom), 12-14 May 2010; Other Information: DOI: 10.1088/1742-6596/279/1/012021
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; 71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSICS; ACCURACY; BEAMS; CALCULI; CLINICAL TRIALS; FRAGMENTATION; IN VITRO; INTERACTIONS; KIDNEYS; MONITORS; PATIENTS; PERFORMANCE; SECONDARY EMISSION; SHOCK WAVES; SURGERY; ULTRASONIC WAVES; BODY; EMISSION; MEASURING INSTRUMENTS; MEDICINE; ORGANS; SOUND WAVES; TESTING
OSTI ID:
21566026
Country of Origin:
United Kingdom
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 1742-6596; TRN: GB12O8295044455
Availability:
Available from http://dx.doi.org/10.1088/1742-6596/279/1/012021
Submitting Site:
GBN
Size:
6 pages
Announcement Date:
Jun 22, 2012

Citation Formats

Fedele, F, Coleman, A J, Thomas, K, Ryves, S, Phillips, D, and Leighton, T G, E-mail: fiammetta.fedele@gstt.nhs.uk. A passive acoustic monitor of treatment effectiveness during extracorporeal lithotripsy. United Kingdom: N. p., 2011. Web. doi:10.1088/1742-6596/279/1/012021.
Fedele, F, Coleman, A J, Thomas, K, Ryves, S, Phillips, D, & Leighton, T G, E-mail: fiammetta.fedele@gstt.nhs.uk. A passive acoustic monitor of treatment effectiveness during extracorporeal lithotripsy. United Kingdom. doi:10.1088/1742-6596/279/1/012021.
Fedele, F, Coleman, A J, Thomas, K, Ryves, S, Phillips, D, and Leighton, T G, E-mail: fiammetta.fedele@gstt.nhs.uk. 2011. "A passive acoustic monitor of treatment effectiveness during extracorporeal lithotripsy." United Kingdom. doi:10.1088/1742-6596/279/1/012021. https://www.osti.gov/servlets/purl/10.1088/1742-6596/279/1/012021.
@misc{etde_21566026,
title = {A passive acoustic monitor of treatment effectiveness during extracorporeal lithotripsy}
author = {Fedele, F, Coleman, A J, Thomas, K, Ryves, S, Phillips, D, and Leighton, T G, E-mail: fiammetta.fedele@gstt.nhs.uk}
abstractNote = {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.}
doi = {10.1088/1742-6596/279/1/012021}
journal = {Journal of Physics. Conference Series (Online)}
issue = {1}
volume = {279}
place = {United Kingdom}
year = {2011}
month = {Feb}
}