Significance of Fluorescence Cystoscopy for Diagnosis of Superficial Bladder Cancer after Intravesical Instillation of Delta Aminolevulinic Acid

Publisher： Karger

E-ISSN： 1423-0399|67|4|298-304

ISSN： 0042-1138

Source： Urologia Internationalis, Vol.67, Iss.4, 2001-12, pp. : 298-304

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Abstract

Objectives: Most lesions of superficial bladder cancer may be easily missed during conventional white light cystoscopy. The aim of this work was to evaluate the efficiency of endoscopic fluorescence diagnosis of superficial malignant bladder tumours following intravesical instillation of δ-aminoleviulenic acid. Patients and Methods: 30 patients of suspected or previously diagnosed bladder cancer were subject of evaluation. All patients received 50 ml of a 3% δ-ALA solution intravesically, 2–3 h prior to diagnostic cystoscopy. Fluorescence excitation intraoperatively was achieved by a violet-blue light from a xenon light source. Results: A clear strong red fluorescence colour was observed emitting from all malignant vesical lesions. A diagnostic sensitivity of 98% and specificity of 65% has been determined for this novel diagnostic modality. Conclusion: Fluorescence cystoscopy using δ-ALA is a reliable procedure that can be offered to all patients with suspected bladder cancer lesions.