Department of Urology, National Cheng Kung University Hospital, College of Medicine, Tainan, Taiwan.
J Urol. 2013 Jun;189(6):2357-63. doi: 10.1016/j.juro.2012.11.111. Epub 2012 Nov 27.
Extracorporeal shock wave lithotripsy has been popular since the 1980s. Only 30% to 50% of the shock waves of all conventional lithotripters are focused on stones. We developed an ultrasound based, real-time stone tracking system (version 1) to improve accuracy and treatment efficiency. However, some problems remained. We revised the existing system (version 2) and tested its reliability and performance.
We revised the system by adding more algorithms to decrease renal stone misidentification. We verified the advanced system by 2 tests using no tracking and tracking with 13 stone trajectories for versions 1 and 2. We performed the coincidence test to evaluate the accuracy of targeting the stone within the effective focal area and the stone fragmentation efficiency test to clarify the decrease in the number of shocks needed for stone fragmentation.
In the coincidence test the mean ± SD results of the nontracking system, and tracking versions 1 and 2 were 68.8% ± 18.8%, 89.9% ± 5.2% and 94.3% ± 4.5%, respectively. Version 2 was statistically significantly better than version 1 (p = 1.5 × 10(-4)). In the stone fragmentation efficiency test the mean results of the nontracking system, and versions 1 and 2 were 49.5% ± 14.2%, 85.1% ± 4.5% and 89.5% ± 4.2%, respectively. Version 2 was statistically significantly better than version 1 (p = 1.9 × 10(-8)).
The revised tracking system is better than version 1. It improves treatment efficiency, decreases stone misidentification and can shorten treatment time.
体外冲击波碎石术自 20 世纪 80 年代以来一直很流行。所有传统碎石机的冲击波只有 30%到 50%聚焦在结石上。我们开发了一种基于超声的实时结石跟踪系统（版本 1），以提高准确性和治疗效率。然而，仍存在一些问题。我们修改了现有的系统（版本 2），并测试了其可靠性和性能。
我们通过添加更多的算法来减少肾结石的误识别，对系统进行了修改。我们使用无跟踪和跟踪 13 个结石轨迹对版本 1 和 2 进行了 2 项测试，以验证先进的系统。我们进行了一致性测试，以评估将结石靶向到有效焦点区域内的准确性，以及结石碎裂效率测试，以阐明减少结石碎裂所需的冲击波数量。
在一致性测试中，无跟踪系统和跟踪版本 1 和 2 的平均结果分别为 68.8%±18.8%、89.9%±5.2%和 94.3%±4.5%。版本 2 在统计学上显著优于版本 1（p=1.5×10(-4)）。在结石碎裂效率测试中，无跟踪系统和版本 1 和 2 的平均结果分别为 49.5%±14.2%、85.1%±4.5%和 89.5%±4.2%。版本 2 在统计学上显著优于版本 1（p=1.9×10(-8)）。
修订后的跟踪系统优于版本 1。它提高了治疗效率，减少了结石的误识别，并可以缩短治疗时间。
