Advanced acoustic field measurements of shock wave lithotripters

描述（由申请人提供）：本项目的目标是使用线性水听器阵列测量冲击波碎石机（SWL）的瞬时声场。所有以前的SWL声场的测量都是用单元件水听器进行的，只有当声场在冲击与冲击之间没有变化时，这种水听器才有效。具体来说，我们建议1）基于为高频成像阵列开发的技术制造线性水听器阵列，2）对阵列进行电气和声学表征，3）驱动阵列失效以确定耐用性，以及4）测试SWL设备中的阵列以提高对瞬时声场的理解。所提出的测量将代表SWL声场的第一个瞬时“快照”，并将对碎石机设备设计、结石破碎的理论模型、设备校准和患者管理产生广泛影响。近25年来，SWL一直被用于非侵入性治疗肾结石，并且在需要医疗干预时用于50%的治疗。根据国家糖尿病、消化和肾脏疾病研究所的数据，20至74岁的成年人中有5.2%患有肾结石，每年有171,000名成年人需要住院治疗“肾结石和输尿管结石”。尽管“改进的”SWL系统已经上市，但最初的Dornier HM 3仍然被认为是治疗的黄金标准。然而，HM 3的声场在单点测量时变化高达50%。这种变化被认为可以改善结石破碎，但也增加了对周围肾组织造成创伤的可能性。拟议的线性水听器阵列将由Ketterling博士在RRI制造。最初的阵列设计将有20个元件，跨度为18 mm。在RRI验证阵列的基本操作后，将制造更多的阵列，并发送给波士顿大学的Cleveland博士和华盛顿大学的Bailey博士。然后，该阵列将被用来进行第一次瞬时声场测量的三个主要类别的SWL系统：电动液压，电磁和压电碎石机。测量将产生有关瞬时声场的尺寸和峰值压力位置、不同反射器对声场的影响以及新电极与旧电极的性能的重要信息。该项目的成功结果最终将有助于通过更有效的碎石提高临床疗效，并通过减少组织损伤提高临床安全性。公共卫生相关性：这项工作的最终目标是通过更有效地破碎结石，同时将周围的肾组织暴露于最小的创伤，来提高肾结石的冲击波碎石术（SWL）治疗的疗效。所提出的测量将代表SWL系统的第一个瞬时声场测量，并将提供有价值的信息，可用于改进碎石机设备，结石破碎的理论模型，设备校准和患者管理。

DESCRIPTION (provided by applicant): The goal of this project is to measure the instantaneous acoustic field of shock wave lithotripters (SWL) using a linear hydrophone array. All previous measurements of SWL acoustic fields have been performed with single-element hydrophones which are only effective if the sound field does not vary from shock to shock. Specifically, we propose to 1) fabricate linear hydrophone arrays based on techniques developed for high-frequency imaging arrays, 2) characterize the arrays electrically and acoustically, 3) drive the arrays to failure to determine durability, and 4) test the arrays in SWL devices to improve the understanding of the instantaneous acoustic field. The proposed measurements would represent the first instantaneous "snapshot" of an SWL acoustic field and would have broad implications for lithotripter device design, theoretical models of stone fragmentation, device calibration, and patient management. SWL has been employed for nearly 25 years to non-invasively treat kidney stones and is utilized in H 50% of the treatments when medical intervention is required. According to the National Institute of Diabetes and Digestive and Kidney Diseases, 5.2% of adults aged 20 to 74 have had kidney stones and H 171,000 adults require a hospital stay each year to undergo treatment of "calculus of kidney and ureters." Even though "improved" SWL systems have come to market, the original Dornier HM3 is still considered the gold standard in treatment. However, the acoustic field of the HM3, when measured at a single point, varies by as much as 50%. This variation is thought to improve stone fragmentation but it also increases the likelihood of trauma to the surrounding kidney tissue. The proposed linear hydrophone array will be fabricated at RRI by Dr. Ketterling. The initial array design will have 20 elements and span 18 mm. After validating the basic operation of the array at RRI, additional arrays will be fabricated and sent to Dr. Cleveland at Boston University and Dr. Bailey at the University of Washington. The arrays will then be employed to make the first instantaneous acoustic field measurements of the three major classes of SWL systems: electrohydraulic, electromagnetic, and piezoelectric lithotripters. The measurements will yield important information about the dimensions and peak pressure location of the instantaneous acoustic field, the effect on the acoustic field of different reflectors, and the performance of new versus old electrodes. A successful outcome of this project will, ultimately, help improve clinical efficacy through more efficient stone fragmentation and improve clinical safety by reducing tissue damage. PUBLIC HEALTH RELEVANCE: The ultimate goal of this work is to improve the efficacy of shock wave lithotripsy (SWL) treatment of kidney stones by more efficiently fragmenting the stones while exposing the surrounding kidney tissue to minimal trauma. The proposed measurements would represent the first instantaneous acoustic field measurements of SWL systems and would provide valuable information that could be used to improve lithotripter devices, theoretical models of stone fragmentation, device calibration, and patient management.