5-aminolevulinic acid-induced (ALA) fluorescence for the laparoscopic diagnosis of peritoneal metastasis. AST An experimental study.
BACKGROUND
We performed a randomized experimental study in a rat model to evaluate the use of 5-aminolevulinic acid-induced (ALA) fluorescence in the laparoscopic diagnosis of peritoneal metastases of ovarian cancer.


METHODS
We injected 103 ovarian adenocarcinoma cells in the peritoneum of 31 rats. One week later, 5-aminolevulinic acid was injected in the peritoneum (100 mg/kg). After 3 h, we examined the rats using a 10-mm endoscope with a mono CCD camera and a light source developed for photodynamic diagnosis. Metastases on the parietal peritoneum were evaluated independently by two surgeons randomly assigned to use either a conventional light mode or the fluorescence mode.


RESULTS
The mean number of metastases detected was 2.84 with conventional laparoscopic light and 5.74 with ALA-induced fluorescence (p < 0.0008). Metastases diagnosed by fluorescence were confirmed by pathologic examination. Random peritoneal biopsy specimens taken from nonfluorescent areas were negative.


CONCLUSIONS
In this experiment, ALA-induced fluorescence improved the detection of peritoneal metastases of ovarian cancer.
Canis
M
M
Department of Obstetrics, Gynecology, and Reproductive Medicine, CHU, 13 Boulevard Charles de Gaulle, 63033 Clermont Ferrand, France. mcanis@chu-clermontferrand.fr
Botchorishvili
R
R
Berreni
N
N
Manhes
H
H
Wattiez
A
A
Mage
G
G
Pouly
J L
JL
Bruhat
M A
MA
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000556:secondary*; D000622:Aminolevulinic Acid; D000818:Animals; D005260:Female; D005453:Fluorescence; D010535:Laparoscopy / Q000379:methods*; D010051:Ovarian Neoplasms / Q000473:pathology*; D010534:Peritoneal Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D051381:Rats; D014407:Tumor Cells, Cultured
D000622:Aminolevulinic Acid