5A-5 Identification of Kidney Stone Fragmentation in Shock Wave Lithotripsy

Identification of stone fragmentation, or comminution, during shock wave lithotripsy (SWL) would aid a urologist in determining the treatment endpoint, but there is currently little feedback available to do so. Here we report the measurement and analysis of SW scattering by kidney stone models in water to study the inverse relationship between stone size and scatter frequency. Stones were exposed to 20 SWs, 120 SWS, or 220 SWs to measure scatter and cause different levels of comminution. Measured scatter signals were processed in frequency to study the effect of stone comminution on the distribution of spectral energy. Comminution was measured by normalizing the mass of stone fragments, separated by size, to the mass of an intact stone. Output from frequency analysis was compared with percent mass comminution, and the shift of spectral energy to higher frequencies was proportional to the percent mass of stone fragments smaller than 2 mm.