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Flat urothelial lesions as well as small papillary tumors are easily missed during transurethral resection (TUR). PDD is based on the detection of protoporphyrin-IX induced fluorescence after topical administration of 5- aminolevulinic acid (ALA). We report on our initial clinical results of 130 procedures in 98 patients. Two hours prior to TUR 1.5 g ALA dissolved in 50 ml 1.4% NaHCO3 solution was installed intravesically. For fluorescence excitation a blue light source (375-440 nm, Karl Storz) was used. In total 478 biopsies (2-9 per patient) were taken from fluorescent and nonfluorescent areas. Normal nonfluorescent bladder urothelium was blue, whereas cancer epithelium developed a brilliant red fluorescence. During white light cystoscopy, 143 bladder tumors were found. Sixty-three additional tumors were detected because of their positive fluorescence. The overall sensitivity of fluorescence cystoscopy (98%) was greater than that of white light cystoscopy (69%). Their specificities were 51% and 80% respectively.
Matthijs C. M. Grimbergen,T. G. N. Jonges,M. Tycho W.T. Lock,Christiaan F. P. van Swol,Tom A. Boon, andR. Jeroen A. van Moorselaar
"Photodynamic diagnosis (PDD) of bladder cancer with intravesical 5-aminolevulinic-acid-induced fluorescence", Proc. SPIE 4244, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems XI, (21 May 2001); https://doi.org/10.1117/12.427813
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Matthijs C. M. Grimbergen, T. G. N. Jonges, M. Tycho W.T. Lock, Christiaan F. P. van Swol, Tom A. Boon, R. Jeroen A. van Moorselaar, "Photodynamic diagnosis (PDD) of bladder cancer with intravesical 5-aminolevulinic-acid-induced fluorescence," Proc. SPIE 4244, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems XI, (21 May 2001); https://doi.org/10.1117/12.427813