title: Seven years' experience with 5-aminolevulinic acid in detection of transitional cell carcinoma of the bladder.
abstract: OBJECTIVE
  Photodynamic diagnosis (PDD) using 5-aminolevulinic acid has proved to be a procedure with an outstanding sensitivity for the detection of transitional cell carcinoma of the bladder, in particular in the detection of flat urothelial lesions. We report on our clinical results with 875 patients (1713 PDD procedures) between March 1995 and March 2002.
  
  
  METHODS
  A total of 1713 PDD procedures were done in 875 patients. Fluorescence imaging was performed 2 to 3 hours after instillation of 50 mL of a 3% solution of 5-aminolevulinic acid into the bladder by an incoherent light source. In total, specimens from 4630 lesions (2.7 lesions/PDD) were taken.
  
  
  RESULTS
  In 34.8% of all biopsies, the histologic finding was malignant; 23.7% of these biopsies had been taken only because of positive fluorescence. In 28.5% of the positive biopsies, flat lesions had been identified. Also, 43.4% of carcinoma in situ and 30.7% of dysplasia II degrees were detected only by positive fluorescence. Of all tumor lesions, 92.0% were detected by PDD compared with 76.3% detected by white light endoscopy.
  
  
  CONCLUSIONS
  PDD has proved to be an effective detection device for superficial bladder cancer.
authors.affiliation: Department of Urology, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany. hungerhuber@gmx.de
authors.forename: Edwin
authors.initials: E
authors.lastname: Hungerhuber
authors.forename: Herbert
authors.initials: H
authors.lastname: Stepp
authors.forename: Martin
authors.initials: M
authors.lastname: Kriegmair
authors.forename: Christian
authors.initials: C
authors.lastname: Stief
authors.forename: Alfons
authors.initials: A
authors.lastname: Hofstetter
authors.forename: Arndt
authors.initials: A
authors.lastname: Hartmann
authors.forename: Ruth
authors.initials: R
authors.lastname: Knuechel
authors.forename: Alexander
authors.initials: A
authors.lastname: Karl
authors.forename: Stefan
authors.initials: S
authors.lastname: Tritschler
authors.forename: Dirk
authors.initials: D
authors.lastname: Zaak
mesh_terms: D000283:Administration, Intravesical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis* / Q000601:surgery; D015331:Cohort Studies; D003558:Cystoscopy / Q000379:methods*; D005260:Female; D005453:Fluorescence; D006801:Humans; D008297:Male; D008875:Middle Aged; D017319:Photosensitizing Agents; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000601:surgery
chemical_list: D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid