title: Transurethral resection and surveillance of bladder cancer supported by 5-aminolevulinic acid-induced fluorescence endoscopy.
abstract: OBJECTIVE
  We determined whether neoplastic disease, which was missed under white light can be found during transurethral resection of bladder cancer by 5-aminolevulinic acid-induced porphyrin fluorescence.
  
  
  METHODS
  5-Aminolevulinic acid-induced fluorescence endoscopy was carried out in 328 cases. A 3% 5-aminolevulinic acid solution was instilled intravesically in a mean time of 2.8 h before endoscopy. The fluorescence was excited by a special incoherent light source which provided blue light in addition to white light.
  
  
  RESULTS
  In 82 (25%) cases additional neoplastic lesions were found only because of their red porphyrin fluorescence which was induced by 5-aminolevulinic acid. 31% of these neoplastic foci which were found in normal and nonspecific inflamed mucosa had a poorly differentiated histology.
  
  
  CONCLUSIONS
  5-Aminolevulinic acid facilitates detection of neoplastic disease during transurethral resection of bladder cancer and increases the accuracy of diagnosis.
authors.affiliation: Department of Urology, University of Munich, and Institute of Pathology, University of Regensburg, Germany. Kriegmair@uro.med.uni-muenchen.de
authors.forename: M
authors.initials: M
authors.lastname: Kriegmair
authors.forename: D
authors.initials: D
authors.lastname: Zaak
authors.forename: H
authors.initials: H
authors.lastname: Stepp
authors.forename: H
authors.initials: H
authors.lastname: Stepp
authors.forename: R
authors.initials: R
authors.lastname: Baumgartner
authors.forename: R
authors.initials: R
authors.lastname: Knuechel
authors.forename: A
authors.initials: A
authors.lastname: Hofstetter
mesh_terms: D000231:Adenocarcinoma, Papillary / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid; D002278:Carcinoma in Situ / Q000473:pathology* / Q000601:surgery; D003558:Cystoscopy / Q000379:methods*; D003937:Diagnosis, Differential; D005069:Evaluation Studies as Topic; D005260:Female; D005453:Fluorescence; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D012680:Sensitivity and Specificity; D014521:Urethra / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery
chemical_list: D000622:Aminolevulinic Acid