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Bailey MR, Maxwell AD, Cao S, Ramesh S, Liu Z, Williams JC, Thiel J, Dunmire B, Colonius T, Kuznetsova E, Kreider W, Sorensen MD, Lingeman JE, Sapozhnikov OA. Improving burst wave lithotripsy effectiveness for small stones and fragments by increasing frequency: theoretical modeling and ex vivo study. J Endourol 2022; 36:996-1003. [PMID: 35229652 DOI: 10.1089/end.2021.0714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION AND OBJECTIVE In clinical trial NCT03873259, a 2.6-mm lower pole stone was treated transcutaneously and ex vivo with 390-kHz burst wave lithotripsy (BWL) for 40 minutes and failed to break. The stone was subsequently fragmented with 650-kHz BWL after a 4-minute exposure. This study investigated how to fragment small stones and why varying BWL frequency may more effectively fragment stones to dust. METHODS A linear elastic model was used to calculate the stress created inside stones from shock wave lithotripsy (SWL) and different BWL frequencies mimicking the stone's size, shape, lamellar structure, and composition. To test model predictions about the impact of BWL frequency, matched pairs of stones (1-5 mm) were treated at 1) 390 kHz, 2) 830 kHz, and 3) 390 kHz followed by 830 kHz. The mass of fragments greater than 1 and 2 mm was measured over 10 minutes of exposure. RESULTS The linear elastic model predicts that the maximum principal stress inside a stone increases to more than 5.5 times the pressure applied by the ultrasound wave as frequency is increased, regardless of composition tested. The threshold frequency for stress amplification is proportionate to the wave speed divided by the stone diameter. Thus, smaller stones may be likely to fragment at higher frequency, but not lower frequency below a limit. Unlike with SWL, this amplification in BWL occurs consistently with spherical and irregularly shaped stones. In water tank experiments, stones smaller than the threshold size broke fastest at high frequency (p=0.0003), whereas larger stones broke equally well to sub-millimeter dust at high, low, or mixed frequency. CONCLUSIONS For small stones and fragments, increasing frequency of BWL may produce amplified stress in the stone causing the stone to break. Using the strategies outlined here, stones of all sizes may be turned to dust efficiently with BWL.
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Affiliation(s)
- Michael R Bailey
- University of Washington, Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, 1013 NE 40th St., Seattle, Washington, United States, 98105;
| | - Adam D Maxwell
- University of Washington School of Medicine, 12353, Department of Urology, 1013 NE 40th St, Seattle, Washington, United States, 98105;
| | - Shunxiang Cao
- California Institute of Technology, Dept. of Mechanical Engineering, Pasadena, California, United States;
| | - Shivani Ramesh
- University of Washington Applied Physics Lab, Center for Industrial and Medical Ultrasound, Seattle, Washington, United States;
| | - Ziyue Liu
- Indiana University School of Medicine, Biostatistics, Indianapolis, Indiana, United States;
| | - James Caldwell Williams
- Indiana Univ Sch Med, Anatomy & Cell Biology, 635 Barnhill Dr MS5035, Department of Anatomy & Cell Biology, Indianapolis, Indiana, United States, 46202-5120.,United States;
| | - Jeff Thiel
- University of Washington School of Medicine, Radiology, Seattle, Washington, United States;
| | - Barbrina Dunmire
- University of Washington, Applied Physics Lab, 1013 NE 40th St, Seattle, Washington, United States, 98105;
| | - Tim Colonius
- California Institute of Technology, Dept. of Mechanical Engineering, Pasadena, California, United States;
| | - Ekaterina Kuznetsova
- University of Washington Applied Physics Lab, Center for Industrial and Medical Ultrasound, Seattle, Washington, United States;
| | - Wayne Kreider
- University of Washington Applied Physics Lab, Center for Industrial and Medical Ultrasound, Seattle, Washington, United States;
| | - Mathew D Sorensen
- University of Washington, Department of Urology, 1959 NE Pacific Street, Box 356510, Seattle, Washington, United States, 98195;
| | - James E Lingeman
- Indiana University School of Medicine, Dept. of Urology, 1801 North Senate Blvd., Suite 220, Indianapolis, Indiana, United States, 46202;
| | - Oleg A Sapozhnikov
- University of Washington Applied Physics Lab, Center for Industrial and Medical Ultrasound, Seattle, Washington, United States.,Moscow State University, 64935, Department of Acoustics, Physics Faculty, Moskva, Moskva, Russian Federation;
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Sapozhnikov OA, Maxwell AD, Bailey MR. Maximizing mechanical stress in small urinary stones during burst wave lithotripsy. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2021; 150:4203. [PMID: 34972267 PMCID: PMC8664414 DOI: 10.1121/10.0008902] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 11/04/2021] [Accepted: 11/09/2021] [Indexed: 06/14/2023]
Abstract
Unlike shock wave lithotripsy, burst wave lithotripsy (BWL) uses tone bursts, consisting of many periods of a sinusoidal wave. In this work, an analytical theoretical approach to modeling mechanical stresses in a spherical stone was developed to assess the dependence of frequency and stone size on stress generated in the stone. The analytical model for spherical stones is compared against a finite-difference model used to calculate stress in nonspherical stones. It is shown that at low frequencies, when the wavelength is much greater than the diameter of the stone, the maximum principal stress is approximately equal to the pressure amplitude of the incident wave. With increasing frequency, when the diameter of the stone begins to exceed about half the wavelength in the surrounding liquid (the exact condition depends on the material of the stone), the maximum stress increases and can be more than six times greater than the incident pressure. These results suggest that the BWL frequency should be elevated for small stones to improve the likelihood and rate of fragmentation.
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Affiliation(s)
- Oleg A Sapozhnikov
- Physics Faculty, Moscow State University, Leninskie Gory, Moscow 119991, Russia
| | - Adam D Maxwell
- Department of Urology, University of Washington School of Medicine, Seattle, Washington 98195, USA
| | - Michael R Bailey
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 40th Street, Seattle, Washington 98105, USA
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Xiang G, Ma X, Liang C, Yu H, Liao D, Sankin G, Cao S, Wang K, Zhong P. Variations of stress field and stone fracture produced at different lateral locations in a shockwave lithotripter field. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2021; 150:1013. [PMID: 34470261 PMCID: PMC8357445 DOI: 10.1121/10.0005823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
During clinical procedures, the lithotripter shock wave (LSW) that is incident on the stone and resultant stress field is often asymmetric due to the respiratory motion of the patient. The variations of the LSW-stone interaction and associated fracture pattern were investigated by photoelastic imaging, phantom experiments, and three-dimensional fluid-solid interaction modeling at different lateral locations in a lithotripter field. In contrast to a T-shaped fracture pattern often observed in the posterior region of the disk-shaped stone under symmetric loading, the fracture pattern gradually transitioned to a tilted L-shape under asymmetric loading conditions. Moreover, the model simulations revealed the generation of surface acoustic waves (SAWs), i.e., a leaky Rayleigh wave on the anterior boundary and Scholte wave on the posterior boundary of the stone. The propagation of SAWs on the stone boundary is accompanied by a progressive transition of the LSW reflection pattern from regular to von Neumann and to weak von Neumann reflection near the glancing incidence and, concomitantly, the development and growth of a Mach stem, swirling around the stone boundary. The maximum tensile stress and stress integral were produced by SAWs on the stone boundary under asymmetric loading conditions, which drove the initiation and extension of surface cracks into the bulk of the stone that is confirmed by micro-computed tomography analysis.
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Affiliation(s)
- Gaoming Xiang
- Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina 27708, USA
| | - Xiaojian Ma
- Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina 27708, USA
| | - Cosima Liang
- Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina 27708, USA
| | - Hongyang Yu
- Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina 27708, USA
| | - Defei Liao
- Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina 27708, USA
| | - Georgy Sankin
- Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina 27708, USA
| | - Shunxiang Cao
- Department of Aerospace and Ocean Engineering, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - Kevin Wang
- Department of Aerospace and Ocean Engineering, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - Pei Zhong
- Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina 27708, USA
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Raymond SJ, Maragh J, Masic A, Williams JR. Towards an understanding of the chemo-mechanical influences on kidney stone failure via the material point method. PLoS One 2020; 15:e0240133. [PMID: 33306670 PMCID: PMC7732073 DOI: 10.1371/journal.pone.0240133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/20/2020] [Indexed: 11/18/2022] Open
Abstract
This paper explores the use of the meshfree computational mechanics method, the Material Point Method (MPM), to model the composition and damage of typical renal calculi, or kidney stones. Kidney stones are difficult entities to model due to their complex structure and failure behavior. Better understanding of how these stones behave when they are broken apart is a vital piece of knowledge to medical professionals whose aim is to remove these stone by breaking them within a patient’s body. While the properties of individual stones are varied, the common elements and proportions are used to generate synthetic stones that are then placed in a digital experiment to observe their failure patterns. First a more traditional engineering model of a Brazil test is used to create a tensile fracture within the center of these stones to observe the effect of stone consistency on failure behavior. Next a novel application of MPM is applied which relies on an ultrasonic wave being carried by surrounding fluid to model the ultrasonic treatment of stones commonly used by medical practitioners. This numerical modeling of Extracorporeal Shock Wave Lithotripsy (ESWL) reveals how these different stones failure in a more real-world situation and could be used to guide further research in this field for safer and more effective treatments.
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Affiliation(s)
- Samuel J. Raymond
- Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States of America
- Center for Computational Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States of America
- * E-mail:
| | - Janille Maragh
- Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States of America
| | - Admir Masic
- Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States of America
| | - John R. Williams
- Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States of America
- Center for Computational Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States of America
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Experimental Investigation and Mechanism Analysis on Rock Damage by High Voltage Spark Discharge in Water: Effect of Electrical Conductivity. ENERGIES 2020. [DOI: 10.3390/en13205432] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
High voltage spark discharge (HVSD) could generate strong pressure waves that can be combined with a rotary drill bit to improve the penetration rate in unconventional oil and gas drilling. However, there has been little investigation of the effect of electrical conductivity on rock damage and the fragmentation mechanism caused by HVSD. Therefore, we conducted experiments to destroy cement mortar, a rock-like material, in water with five conductivity levels, from 0.5 mS/cm to 20 mS/cm. We measured the discharge parameters, such as breakdown voltage, breakdown delay time, and electrical energy loss, and investigated the damage mechanism from stress waves propagation using X-ray computed tomography. Our study then analyzed the influence of conductivity on the surface damage of the sample by the pore size distribution and the cumulative pore area, as well as studied the dependence of internal damage on conductivity by through-transmission ultrasonic inspection technique. The results indicated that the increase in electrical conductivity decreased the breakdown voltage and breakdown delay time and increased the energy loss, which led to a reduction in the magnitude of the pressure wave and, ultimately, reduced the sample damage. It is worth mentioning that the relationship between the sample damage and electrical conductivity is non-linear, showing a two-stage pattern. The findings suggest that stress waves induced by the pressure waves play a significant role in sample damage where pores and two types of tensile cracks are the main failure features. Compressive stresses close horizontal cracks inside the sample and propagate vertical cracks, forming the tensile cracks-I. Tensile stresses generated at the sample–water interface due to the reflection of stress waves produce the tensile cracks-II. Our study is the first to investigate the relationship between rock damage and electrical conductivity, providing insights to guide the design of drilling tools based on HVSD.
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