PD26-02 FLUOROSCOPIC TARGETING OF RENAL CALCULI DURING EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY USING A MACHINE LEARNING ALGORITHM

INTRODUCTION AND OBJECTIVES:The efficacy of Extracorporeal Shockwave Lithotripsy (ESWL) is influenced by the time spent delivering focused energy to the stone. Manual targeting occurs at the start of the procedure, but subsequent respiration and movement significantly reduce the time that the stone is in the crosshairs. Radiographic appearance varies between stones and may change during treatment which makes targeting difficult. These effects result in increased radiation exposure and operative duration with increased shockwave exposure to surrounding structures in addition to decreased efficacy of stone fragmentation. There is a need for improved stone targeting to improve care. We propose a computer vision algorithm to locate stones during ESWL treatment.METHODS:2413 fluoroscopic images from n=102 subjects that underwent ESWL were manually annotated followed by secondary review for annotation agreement (CL, CF, DH). A bounding box was drawn around any stone present. The algorithm RetinaNet was trained u...