Fluorescence detection of flat transitional cell carcinoma after intravesical instillation of aminolevulinic acid

Marie-Ange D'Hallewin M.D.; Herman A. Vanherzeele; Luc Baert M.D.

doi:10.1117/12.297949

29 December 1997 Fluorescence detection of flat transitional cell carcinoma after intravesical instillation of aminolevulinic acid

Marie-Ange D'Hallewin M.D., Herman A. Vanherzeele, Luc Baert M.D.

Author Affiliations +

Proceedings Volume 3197, Optical Biopsies and Microscopic Techniques II; (1997) https://doi.org/10.1117/12.297949
Event: BiOS Europe '97, 1997, San Remo, Italy

Abstract

Carcinoma in situ (CIS) of the bladder is a confounding disease that is difficult to recognize endoscopically since it is a flat cancer. Many studies have suggested its relationship with subsequent invasive disease. Early recognition of CIS therefore is essential in order to offer the patients the most appropriate treatment and the highest cure rate. Since white light cystoscopic examination is not sufficient to reveal areas of dysplasia or carcinoma in situ random biopsies are recommended. We wanted to evaluate whether amino levulinic acid (ALA) fluorescence detection could be helpful in diagnosing carcinoma in situ and if the specificity could be enhanced by reducing the ALA dose. Sixteen patients with papillary bladder cancer and carcinoma in situ and dysplasia were instilled with low dose ALA. Fluorescence detection of the metabolized ALA was performed three hours later, with the naked eye, after blue light illumination. CIS or dysplasia was found in 50 biopsies. The sensitivity for detecting CIS was 94% with a specificity of 89%. Carcinoma in situ can be diagnosed with a very high accuracy through fluorescence detection after ALA instillation. Fluorescence detection can be achieved with the naked eye and does not necessitate complex equipment neither specifically trained personnel.

Citation Download Citation

Marie-Ange D'Hallewin M.D., Herman A. Vanherzeele, and Luc Baert M.D. "Fluorescence detection of flat transitional cell carcinoma after intravesical instillation of aminolevulinic acid", Proc. SPIE 3197, Optical Biopsies and Microscopic Techniques II, (29 December 1997); https://doi.org/10.1117/12.297949

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