# Innovations in Shock Wave Lithotripsy Technology

> **NIH NIH R01** · DUKE UNIVERSITY · 2024 · $524,986

## Abstract

SUMMARY ABSTRACT
Urolithiasis imposes a substantial and growing public health burden in the United States with a prevalence nearly
doubled over the past 15 years, impacting now 1 in 11 Americans in their lifetime. Shock wave lithotripsy (SWL)
remains to be the only non-invasive treatment option for kidney stone patients despite the advances in
ureteroscopy. The progressive decline in the clinic use of SWL, on the other hand, has been attributed to several
key factors, including 1) no fundamental technology breakthrough with problematic dry coupling technique widely
employed by contemporary shock wave lithotripters, 2) no real-time monitoring of cavitation activity during clinical
SWL, and 3) increased number of shockwaves administered per session with elevated fragment size and non-
successful rate. Overall, addressing these critical issues is urgently needed to improve the efficiency and safety
of SWL, and ultimately, reinvigorate the confidence of urologists in this non-invasive treatment modality for stone
patients. In this competing R01 renewal application, we will leverage the knowledge and expertise that our
interdisciplinary team has accumulated in the past ten years through the R37 program. We will focus on
developing the next-generation SWL, cavitation monitoring, and
miniature
wet coupling technologies as well as
strategies to produce fine stone fragments in SWL with clear translational potentials. We propose three specific
aims: 1) create a SAFE (Steerable and Adjustable Focusing Electrohydraulic) shock wave generator with flexible
focal width and beam orientation, and a miniature wet coupling device, 2) develop 3D Dynamic Cavitation
Monitoring (3D-DCM) technology for safeguarding SWL
while improving stone fragmentation efficiency and
treatment outcome
, and 3) investigate mechanism of surface acoustic wave (SAW) generation and its
contribution to producing fine fragments through synergistic interaction with cavitation in SWL. Achieving these
aims will significantly advance the state-of-the-art research activities in SWL, and further propel technology
development in the field in close collaboration with lithotripter manufacturers. The new technologies envisioned
in this project will improve the safety and efficacy of SWL, while providing the urologist opportunity and flexibility
in tailor-designing the treatment protocol for stone patients under various clinical scenarios.

## Key facts

- **NIH application ID:** 10817889
- **Project number:** 5R01DK052985-27
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** PEI ZHONG
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $524,986
- **Award type:** 5
- **Project period:** 1997-09-10 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10817889

## Citation

> US National Institutes of Health, RePORTER application 10817889, Innovations in Shock Wave Lithotripsy Technology (5R01DK052985-27). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10817889. Licensed CC0.

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