Transurethral resection and surveillance of bladder cancer supported by 5-aminolevulinic acid-induced fluorescence endoscopy.
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.
Kriegmair
M
M
Department of Urology, University of Munich, and Institute of Pathology, University of Regensburg, Germany. Kriegmair@uro.med.uni-muenchen.de
Zaak
D
D
Stepp
H
H
Stepp
H
H
Baumgartner
R
R
Knuechel
R
R
Hofstetter
A
A
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
D000622:Aminolevulinic Acid