Significance of fluorescence cystoscopy for diagnosis of superficial bladder cancer after intravesical instillation of delta aminolevulinic acid.
OBJECTIVE
Most lesions of superficial bladder cancer may be easily missed during conventional white light cystoscopy. The aim of this work was to evaluate the efficiency of endoscopic fluorescence diagnosis of superficial malignant bladder tumours following intravesical instillation of delta-aminoleviulenic acid.


METHODS
30 patients of suspected or previously diagnosed bladder cancer were subject of evaluation. All patients received 50 ml of a 3% delta-ALA solution intravesically, 2-3 h prior to diagnostic cystoscopy. Fluorescence excitation intraoperatively was achieved by a violet-blue light from a xenon light source.


RESULTS
A clear strong red fluorescence colour was observed emitting from all malignant vesical lesions. A diagnostic sensitivity of 98% and specificity of 65% has been determined for this novel diagnostic modality.


CONCLUSIONS
Fluorescence cystoscopy using delta-ALA is a reliable procedure that can be offered to all patients with suspected bladder cancer lesions.
Ehsan
A
A
Department of Urology, University of Cologne, Germany. amgad.ehsan@uni-koeln.de
Sommer
F
F
Haupt
G
G
Engelmann
U
U
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D000283:Administration, Intravesical; D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid; D001706:Biopsy; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000473:pathology; D003558:Cystoscopy / Q000379:methods / Q000592:standards*; D005260:Female; D005453:Fluorescence; D006801:Humans; D008297:Male; D008875:Middle Aged; D017319:Photosensitizing Agents; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000473:pathology
D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid