Experimental and numerical evaluation of the effect of stone size on fracture by burst wave

lithotripsy

Authors: Madeline Hubbard, Barbrina Dunmire, Oleg Sapozhnikov, Wayne Kreider, Michael
Bailey, and Adam Maxwell

Burst wave lithotripsy (BWL) is an experimental treatment to noninvasively fragment kidney

stones using bursts of focused ultrasound. Preliminary simulations with a linear elastic model
showed that resonance creates concentrated stresses, which may help predict locations of
fractures in the stones. In this study, we aimed to demonstrate this correlation by comparing
simulations to experimental data. Cylindrical stones of variable size (4-14 mm diameter, 10 mm
length) made from BegoStone plaster were treated in a water bath for 10 minutes using a 170
kHz focused transducer at a focal pressure of 6.5 MPa. Locations of first fractures in the stones
correlated well with the location of peak stress predicted in the linear elastic model. Simulated
peak surface stress in the stones decreased as stone diameter increased, with the exception of
a spike near d=12 mm, which matches the half longitudinal wavelength in the stone.
Experimentally, a corresponding overall increase in time to first fracture was observed with
diameter, except for a drop at d=12 mm. The results are encouraging that the model may help
direct further optimization of BWL. [Work supported by NIH through DK043881, DK104854,
EB007643, and NSBRI through NASA NCC 9-58.]