Acoustic emission of kidney stones: a medical adaptation of statistical breakdown mechanisms.

ABSTRACT

Kidney stones have a prevalence rate of > 10% in some countries. There has been a significant increase in surgery to treat kidney stones over the last 10 years, and it is crucial that such techniques are as effective as possible, while limiting complications. A selection of kidney stones with different chemical and structural properties were subjected to compression. Under compression, they emit acoustic signals called crackling noise. The variability of the crackling noise was surprisingly great comparing weddellite, cystine and uric acid stones. Two types of signals were found in all stones. At high energies of the emitted sound waves, we found avalanche behaviour, while all stones also showed signals of local, uncorrelated collapse. These two types of events are called 'wild' for avalanches and 'mild' for uncorrelated events. The key observation is that the crossover from mild to wild collapse events differs greatly between different stones. Weddellite showed brittle collapse, extremely low crossover energies (< 5 aJ) and wild avalanches over 6 orders of magnitude. In cystine and uric acid stones, the collapse was more complicated with a dominance of local "mild" breakings, although they all contained some stress-induced collective avalanches. Cystine stones had high crossover energies, typically [Formula see text] 750 aJ, and a narrow window over which they showed wild avalanches. Uric acid stones gave moderate values of crossover energies, [Formula see text] 200 aJ, and wild avalanche behaviour for [Formula see text] 3 orders of magnitude. Further research extended to all stone types, and measurement of stone responses to different lithotripsy strategies, will assist in optimisation of settings of the laser and other lithotripsy devices to insight fragmentation by targeting the 'wild' avalanche regime.