Seven years' experience with 5-aminolevulinic acid in detection of transitional cell carcinoma of the bladder.
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.
Hungerhuber
Edwin
E
Department of Urology, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany. hungerhuber@gmx.de
Stepp
Herbert
H
Kriegmair
Martin
M
Stief
Christian
C
Hofstetter
Alfons
A
Hartmann
Arndt
A
Knuechel
Ruth
R
Karl
Alexander
A
Tritschler
Stefan
S
Zaak
Dirk
D
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
D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid