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

Abstract

BACKGROUND:

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).

• Authors: C R Riedl, E Plas, H Pflüger
• Journal: Journal of endourology (J Endourol) Vol. 13 Issue 10 Pg. 755-9 (Dec 1999) ISSN: 0892-7790 [Print] United States
• PMID: 10646684 (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)