scholarly journals A case in which bladder cancer invaded the ureteral orifice and was resected via photodynamic diagnosis‐assisted transurethral resection involving orally administered 5‐aminolevulinic acid

2019 ◽  
Vol 2 (6) ◽  
pp. 313-316
Author(s):  
Keitaro Watanabe ◽  
Suguru Shirotake ◽  
Yuta Umezawa ◽  
Takayuki Takahashi ◽  
Takeshi Yamanaka ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Transurethral Resection ◽  
Aminolevulinic Acid ◽  
Photodynamic Diagnosis ◽  
Ureteral Orifice

Significance of 5-Aminolevulinic Acid-mediated Photodynamic Diagnosis Following Standard Transurethral Resection in Non-muscle Invasive Bladder Cancer

2021 ◽  
Vol 1 (3) ◽  
pp. 201-205
Author(s):  
KYOHEI WATANABE ◽  
KEITA TAMURA ◽  
YUTO MATSUSHITA ◽  
HIROMITSU WATANABE ◽  
DAISUKE MOTOYAMA ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Diagnostic Accuracy ◽  
Transurethral Resection ◽  
Aminolevulinic Acid ◽  
Photodynamic Diagnosis ◽  
Urinary Cytology ◽  
Residual Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive ◽  
Additional Resection

Background/Aim: Transurethral resection of bladder tumors (TURBT) guided by photodynamic diagnosis (PDD) with 5-aminolevulinic acid (5-ALA) has been shown to be superior to conventional white light (WL) cystoscopy with regard to diagnostic accuracy, for non-muscle invasive bladder cancer (NMIBC); however, PDD is usually performed prior to WL TURBT. The objective of this study was to investigate the diagnostic significance of 5-ALA-mediated PDD following TUR of NMIBC. Patients and Methods: In 83 NMIBC patients, all visible tumors were completely resected under the conventional WL guidance followed by additional resection if fluorescent lesions were observed under the blue light (BL) guidance, and random biopsy was further conducted. Results: With the BL source, 39 (47.0%) patients were judged to have fluorescent lesions. Twenty (51.3%) of the 39 patients with positive findings by PDD were diagnosed with residual cancer by additional resection, while random biopsy detected cancers in 2 (4.5%) of the 44 patients with negative findings by PDD. Accordingly, the sensitivity, specificity, positive predictive value and negative predictive value in diagnosing residual cancer by our PDD system were 90.9, 68.9, 51.3 and 95.5%, respectively. Univariate analysis showed that the presence of residual cancers shown by WL TURBT was significantly associated with the preoperative findings of urinary cytology, tumor multiplicity, pathological T stage and tumor grade, of which only the preoperative finding on urinary cytology was shown to have an independent impact on the diagnosis of residual cancer. Conclusion: 5-ALA-mediated PDD following standard WL TURBT could improve the diagnostic accuracy in NMIBC patients, particularly those who are positive for preoperative urinary cytology.

scholarly journals Comparison Between 5-Aminolevulinic Acid Photodynamic Diagnosis and Narrow- Band Imaging for Bladder Cancer Detection: A Single-Center Retrospective Cohort Study

2021 ◽  
Author(s):  
Hiroki Hagimoto ◽  
Noriyuki Makita ◽  
Yuta Mine ◽  
Hidetoshi Kokubun ◽  
Shiori Murata ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Cancer Detection ◽  
White Light ◽  
Transurethral Resection ◽  
Aminolevulinic Acid ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Photodynamic Diagnosis ◽  
Bladder Tumors

Abstract BackgroundNo comparative studies exist between 5-aminolevulinic acid-photodynamic diagnosis (PDD) and narrow-band imaging (NBI) for the detection of urothelial carcinoma. Therefore, we compared 5-aminolevulinic acid-mediated PDD with NBI for cancer detection during transurethral resection of bladder tumors.MethodsBetween June 2018 and October 2020, 114 patients and 282 lesions were included in the analysis. Patients were orally administered 5-aminolevulinic acid (20 mg/kg) 2 h before transurethral resection of bladder tumors. The bladder was inspected with white light, PDD, and NBI for each patient and all areas that were positive by at least one method were resected or biopsied. The imaging data were then compared to the pathology results.ResultsThe sensitivity, specificity, positive predictive value, and negative predictive value for detecting urothelial carcinoma were 88.1%, 47.5%, 80.9%, and 61.3% for white light; 89.6%, 22.5%, 74.5%, and 46.2% for PDD; and 76.2%, 46.3%, 78.2%, and 43.5% for NBI, respectively. PPD was significantly more sensitive than NBI for all lesions (p<0.001), including carcinoma in situ lesions (94.6% vs. 54.1%, p<0.001).ConclusionsPDD can increase the detection rate of bladder cancer compared to NBI by greater than 10%. Adding PDD to white light can detect 100% of carcinoma in situ lesions.

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