The effects of visual fluorescence marking induced by 5-aminolevulinic acid for endoscopic diagnosis of urinary bladder cancer

During cystoscopy procedure, fluorescence diagnostics induced by 5-ALA improves visual detection of the bladder cancer. Macroscopic ALA-fluorescence allows visualizing of small flat tumors, carcinoma in situ, true neoplasm margins and dysplasias of the bladder. Following ALA instillation, cystoscopy has been performed under both standard and blue light illumination. Totally, 153 biopsies have been carried out at 53 patients with suspicion of bladder cancer. The results were compared to ALA-fluorescence data. In 13% of the patients, bladder cancer and dysplasia were found out in addition, due to red fluorescence. The sensitivity and specificity of ALA-fluorescence technique aggregated 96% and 52% respectively. The sensitivity and specificity of 5-ALA-fluorescent detection exceeded standard endoscopy under white light on 20%. The new method does not exclude a false positive and a false negative fluorescent luminescence. The ALA-based fluorescence detection system enhances the diagnosis of malignant/dysplastic bladder lesions significantly.

[1]  L. Guillou,et al.  Clinical evaluation of a method for detecting superficial transitional cell carcinoma of the bladder by light‐induced fluorescence of protoporphyrin IX following topical application of 5‐aminolevulinic acid: Preliminary results , 1997, Lasers in surgery and medicine.

[2]  W Roessler,et al.  Clinical results of the transurethreal resection and evaluation of superficial bladder carcinomas by means of fluorescence diagnosis after intravesical instillation of 5-aminolevulinic acid. , 1999, Journal of endourology.

[3]  K. Schomacker,et al.  Diagnosis of bladder carcinoma using protoporphyrin IX fluorescence induced by 5‐aminolaevulinic acid , 1999, BJU international.

[4]  C. Riedl,et al.  Fluorescence detection of bladder tumors with 5-amino-levulinic acid. , 1999, Journal of endourology.

[5]  F J McGovern,et al.  Fluorescence detection of bladder carcinoma. , 1997, Urology.

[6]  R Baumgartner,et al.  Fluorescence photodetection of neoplastic urothelial lesions following intravesical instillation of 5-aminolevulinic acid. , 1994, Urology.

[7]  J C Kennedy,et al.  Endogenous protoporphyrin IX, a clinically useful photosensitizer for photodynamic therapy. , 1992, Journal of photochemistry and photobiology. B, Biology.

[8]  Herbert Stepp,et al.  Transurethral Resection and Surveillance of Bladder Cancer Supported by 5-Aminolevulinic Acid-Induced Fluorescence Endoscopy , 1999, European Urology.

[9]  Leitlinien zur Diagnostik und Therapie des Harnblasenkarzinoms Im Auftrag der Deutschen Krebsgesellschaft und ihrer wissenschaftlichen Arbeitsgemeinschaften, der Deutschen Krebshilfe und der Deutschen Gesellschaft für Urologie und in Kooperation mit nachstehend angeführten wissenschaftlichen Fachges , 1998, Der Urologe A.

[10]  H. Huland,et al.  Residual tumor discovered in routine second transurethral resection in patients with stage T1 transitional cell carcinoma of the bladder. , 1991, The Journal of urology.