PURPOSE: To determine the ability of a novel palpation device to differentiate between benign and malignant tissues of the kidney and bladder by measuring tissue elasticity. MATERIALS AND METHODS: A novel palpation device was developed, mainly composed of a micromotor, a linear position sensor, a force transducer, and a hemisphere tip and cylindrical body probe. Motion calibration as well as performance validation was done. The tissue elasticity of both benign and malignant tissues of the kidney and bladder was measured using this device. A single investigator performed the ex-vivo palpation experiment in twelve kidneys and four bladder specimens. Malignant tissues were made available from partial nephrectomy specimens and radical cystectomy specimens. Palpations for benign renal parenchyma tissue were carried out on nephroureterectomy specimens while non-involved areas in the radical cystectomy specimens were used for benign bladder samples. Elastic modulus (Young's modulus) of tissues was estimated using the Hertz-Sneddon equation from the experimental results. These were then compared using a t-test for independent samples. RESULTS: Renal cell carcinoma tissues appear to be softer than normal kidney tissues, whereas tissues from urothelial carcinoma of the bladder appear to be harder than normal bladder tissues. The results from renal cell carcinoma differed significantly from those of normal kidney tissues (p=0.002), as did urothelial carcinoma of the bladder from normal bladder tissues (p=0.003). CONCLUSION: Our novel palpation device can potentially differentiate between malignant and benign kidney and bladder tissues. Further studies are necessary to verify our results and define its true clinical utility.
Adult ; Aged ; Elastic Modulus ; Elasticity Imaging Techniques/*instrumentation ; Equipment Design ; Female ; Humans ; Kidney/physiology ; Kidney Neoplasms/*diagnosis/physiopathology ; Male ; Middle Aged ; Palpation/*instrumentation ; Phantoms, Imaging ; Pilot Projects ; Urinary Bladder/physiology ; Urinary Bladder Neoplasms/*diagnosis/physiopathology

This study was done to analyze the clinical characteristics of renal cell carcinoma (RCC) in Korean patients with von Hippel-Lindau (VHL) disease. Between January 1996 and July 2008, 1,514 patients were diagnosed with RCC and 24 patients were diagnosed with VHL disease at our institute. We analyzed the clinical characteristics of the 24 patients diagnosed with VHL. The mean age of patients with VHL was 39.2+/-12.6 yr; the mean age of patients with both VHL and RCC was 42.5+/-10.3 yr. Among the 24 patients with VHL, 7 patients had retinal angiomas, 11 had RCC, 16 had renal lesions, 18 had pancreatic lesions and 21 had cerebellar hemangioblastomas. There was no significant difference between survival rates of patients with VHL alone and those with VHL and RCC. However, cancer-specific survival rates were significantly different between patients with both VHL and RCC and patients with sporadic bilateral or multifocal RCC. In our Korean study, the incidence of RCC in patients with VHL disease is 45.8% and the incidence of VHL disease in patients with RCC is 0.73%. Due to the low overall incidence of VHL in Korea, extended multi-institutional studies are needed to establish the true characteristics of VHL disease.
Adolescent ; Adult ; Aged ; *Carcinoma, Renal Cell/pathology/physiopathology ; Diagnosis, Differential ; Female ; Humans ; *Kidney Neoplasms/pathology/physiopathology ; Male ; Middle Aged ; Prognosis ; Survival Rate ; Young Adult ; *von Hippel-Lindau Disease/pathology/physiopathology

OBJECTIVETo investigate the perfusion characteristics of renal mass parenchyma on 64-slice spiral computed tomography (CT).

METHODSTotally 91 patients with renal mass were enrolled. Sixty-four slice spiral CT was used for renal perfusion scan that began with a contrast bolus injection of 50 ml (370 mgI/ml) at a rate of 5 ml/s. Perfusion characteristics, including blood flow (BF), blood volume (BV), and permeability (PM) of renal mass parenchyma and renal cortex in affected and normal kidneys were calculated from Siemens Body PCT (VB20B) software, and the perfusion characteristics among renal mass parenchyma and renal cortex in affected and normal kidneys were compared.

RESULTSRenal clear cell carcinoma (RC-CC), renal pelvic transitional cell carcinoma (RPTCC), and renal angiomyolipoma (RAML) was pathologically confirmed in 40, 21, and 16 patients, respectively, while the remaining 14 patients were diagnosed as with renal simple cyst (RSC). Technical failure was experienced in 1 (1.1% ) patient. Perfusion parameters of tumor parenchyma were measured as follow: RCCC, BF (93.7 +/- 20.2) ml x (100 ml)(-1) x min(-1), BV (182.0 +/- 46.6) 1000:1, PM (115.7 +/-30.2) 0.5 ml x (100 ml)(01) x min(-1); RPTCC, BF (48.0 +/- 21.2) ml x (100 ml)(-1) x min(-1), BV (82.4 +/- 29.7) 1000:1, PM (65.7 +/- 17.2) 0.5 ml (100 ml)(-1) x min(-1); RAML, BF (52.6 +/- 18.5) ml x (100 ml)(-1) x min(-1), BV (110.1 +/- 45.9) 1000:1, PM (60.1 +/- 23.0) 0.5 ml x (100 ml)(-1) x min-1; RSC, BF (7.0 +/- 6.5) ml x (100 ml)(-1) min(-1), BV (16.2 +/- 9.7) 1000:1, PM (12.0 +/- 7.2) 0.5 ml x (100 ml) (-1) x min(-1). In all pathological groups, perfusion pa- rameters showed significant differences (P <0 . 1) between mass parenchyma and renal cortex in affected kidney, while there were no significant differences (P > 0. 5) in perfusion characteristics between renal cortex in affected and normal kidneys. Aslo, the perfusion characteristics were significantly different between parenchyma D in any two kinds of renal masses (P <0 . 5) except for RPTCC and RAML (P > 0. 5). C ONCLUSIONS: fDif-rent pathological types of renal mass have different perfusion characteristics. Perfusion imaging with multislice CT is potentially useful in the differential diagnosis of renal mass.

Adult ; Aged ; Blood Volume ; Female ; Humans ; Kidney Neoplasms ; diagnosis ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Perfusion Imaging ; Regional Blood Flow ; Tomography, Spiral Computed ; Young Adult