Detection of nonpigmented endometriotic lesions with 5-aminolevulinic acid-induced fluorescence.
OBJECTIVE
To evaluate the feasibility of fluorescence diagnosis of nonpigmented (red and white) endometriotic lesions with 20 mg/kg of 5-aminolevulinc acid (5-ALA) 5-7 and 10-14 hours before surgery.


METHODS
Prospective analysis (Canadian Task Force classification II-2).


METHODS
University hospital.


METHODS
Twenty-four consecutive patients with suspected endometriosis undergoing laparoscopy.


METHODS
Laparoscopic surgery under white light illumination and fluorescence diagnosis.


RESULTS
The total number of endometriotic lesions detected under white light illumination was compared with the number of lesions detected with fluorescence diagnosis. Fluorescence diagnosis yielded an overall improvement of 35% in the detection of nonpigmented endometriotic lesions compared with white light illumination. Sensitivity (91%) and specificity (79%) were similar 5-7 and 10-14 hours before surgery.


CONCLUSIONS
The dosage of 20 mg/kg body weight of 5-ALA is feasible for fluorescence diagnosis of nonpigmented endometriosis. Sensitivity of fluorescence diagnosis with 20 mg/kg is similar to that achieved with a 30-mg/kg dose. Sensitivity does not change within the application period 5-7 and 10-14 hours before surgery.
Buchweitz
Olaf
O
Department of Obstetrics and Gynecology, University of Münster, Albert Schweitzer Strasse 33, D-48149 Münster, Germany.
Wülfing
Pia
P
Staebler
Anette
A
Kiesel
Ludwig
L
D000328:Adult; D000622:Aminolevulinic Acid; D004715:Endometriosis / Q000175:diagnosis*; D005260:Female; D005453:Fluorescence; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D017319:Photosensitizing Agents; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013997:Time Factors
D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid