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Fluorescence detection of bladder tumors with 5-amino-levulinic acid.

AbstractBACKGROUND:
Preliminary data suggest that photodiagnosis by fluorescence detection of protoporphyrin IX, a biosynthetic product of the photosensitizer 5-amino-levulinic acid (ALA), is superior to conventional cystoscopy in bladder tumor detection.
PATIENTS AND METHODS:
We instilled 1.5 g of ALA into the bladders of 52 patients with suspect bladder lesions 1 to 4 hours prior to transurethral resection or biopsy. Red fluorescence was induced by violet-blue light (wavelength 380-450 nm).
RESULTS:
In 13 patients (25%), significant tumors were detected by fluorescence that were missed on conventional cystoscopy. In the present series, ALA photodetection had a sensitivity of 94.6% (compared with 76% for cystoscopy) and a specificity of 43%.
CONCLUSION:
Fluorescence diagnosis with ALA may become a standard procedure for bladder tumor detection and resection, especially in endoscopically difficult situations (carcinoma in situ, multifocal tumors, multiple prior resections, or previous drug instillation therapy).
AuthorsC R Riedl, E Plas, H Pflüger
JournalJournal of endourology / Endourological Society (J Endourol) Vol. 13 Issue 10 Pg. 755-9 (Dec 1999) ISSN: 0892-7790 [Print] UNITED STATES
PMID10646684 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • Photosensitizing Agents
  • Aminolevulinic Acid
Topics
  • Adult
  • Aged
  • Aminolevulinic Acid
  • Cystoscopy
  • Fluorescence
  • Humans
  • Middle Aged
  • Photosensitizing Agents
  • Sensitivity and Specificity
  • Urinary Bladder Neoplasms (pathology)

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