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Performance of brushite plaster as kidney stone phantoms for laser lithotripsy

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Abstract

Artificial phantoms used in photothermal near-infrared laser lithotripsy research generally fail to mimic both the chemical and the physical properties of human stones. Though high-energy, 1 J pulses are capable of fracturing hard human stones into several large fragments along natural boundaries, similar behavior has not been observed in commonly used gypsum plasters like BegoStone. We developed a new brushite-based plaster formulation composed of ≈90% brushite that undergoes rapid fracture in the manner of human stones under fragmentation pulse regimes. Single-pulse (1 J) ablation crater volumes for phantoms were not significantly different from those of pure brushite stones. Control over crater volumes was demonstrated by varying phosphorous acid concentration in the plaster formulation. Fragmentation of cylindrical brushite phantoms was filmed using a high-speed camera which demonstrated rapid fragmentation in < 100 µs during the bubble expansion phase of a short pulse from a high-powered Ho:YAG laser (Lumenis Pulse 120 H). The rapid nature of observed fracture suggests increasing laser pulse energy by increasing laser pulse duration will not improve fragmentation performance of laser lithotripters. Brushite plaster phantoms are a superior alternative to gypsum plasters for laser lithotripsy research due to their better mimicry of stone composition, controllable single-pulse crater volumes, and fragmentation behavior.

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Funding

Funding for this research was provided through a research grant from Boston Scientific.

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Authors and Affiliations

  1. Department of Chemistry, University of Michigan, Ann Arbor, MI, 48109, USA

    John W. Robinson & Adam J. Matzger

  2. Division of Endourology, Department of Urology, University of Michigan, Ann Arbor, MI, 48109, USA

    Ron Marom, Khurshid R. Ghani & William W. Roberts

  3. Department of Urology, Tel Aviv Medical Center, Tel Aviv, Israel

    Ron Marom

  4. Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA

    William W. Roberts

  5. Macromolecular Science and Engineering Program, University of Michigan, Ann Arbor, MI, 48109, USA

    Adam J. Matzger

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Contributions

JWR was the primary developer of new materials and experimental methodology for this work. RM aided JWR in developing and performing lithotripsy experiments. AJM and WWR: supervised experimental work. All authors contributed to conceptualization. JWR: wrote the first draft of this manuscript and all authors contributed to editing and review of the manuscript.

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Correspondence to Adam J. Matzger.

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Conflict of interest

William W. Roberts has a consulting relationship with Boston Scientific. Khurshid R Ghani has a consulting relationship with Boston Scientific, Ambu, Coloplast, Karl Storz and Olympus.

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Robinson, J.W., Marom, R., Ghani, K.R. et al. Performance of brushite plaster as kidney stone phantoms for laser lithotripsy. Urolithiasis 52, 10 (2024). https://doi.org/10.1007/s00240-023-01505-8

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