Detection of Early Bladder Cancer by 5-Aminolevulinic Acid Induced Porphyrin Fluorescence

Kriegmair, M.; Baumgartner, Reinhold; Knüchel, Ruth; Stepp, Herbert; Hofstädter, Ferdinand; Hofstetter, A.

doi:10.1016/s0022-5347(01)66559-5

Cited by 365 publications

(162 citation statements)

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“…However, clinically useful fluorescent probes are limited. 5-ALA has few side effects and is a safe drug that has previously been used to diagnose glioma and bladder cancer (7–10). In urology, the sensitivity of detecting dysplasia or early bladder cancer with fluorescence cystoscopy (96.9%) is significantly higher than that for white light cystoscopy (72.7%) (7).…”

Section: Discussionmentioning

confidence: 99%

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Fluorescent detection of peritoneal metastasis in human colorectal cancer using 5-aminolevulinic acid

Kondo

Murayama

Konishi

et al. 2014

International Journal of Oncology

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A precise diagnosis of peritoneal dissemination is necessary to determine the appropriate treatment strategy for colorectal cancer. However, small peritoneal dissemination is difficult to diagnose. 5-aminolevulinic acid (5-ALA) is an intermediate substrate of heme metabolism. The administration of 5-ALA to cancer patients results in tumor-specific accumulation of protoporphyrin IX (PpIX), which emits red fluorescence with blue light irradiation. We evaluated the usefulness of photodynamic diagnosis (PDD) using 5-ALA to detect the peritoneal dissemination of colorectal cancer. EGFP-tagged HT-29 cells were injected into the peritoneal cavity of BALB/c nude mice. After 2 weeks, the mice were given 5-ALA hydrochloride, and metastatic nodules in the omentum were observed with white light and fluorescence images. Twelve colorectal cancer patients suspected to have serosal invasion according to preoperative computed tomography (CT) were enrolled in this study. 5-ALA (15-20 mg per kg body weight) was administered orally to the patients 3 h before surgery. The abdominal cavity was observed under white light and fluorescence. Fluorescence images were analyzed with image analysis software (ImageJ 1.45s, National Institutes of Health, Bethesda, MD, USA). The mice developed peritoneal disseminations. The observed 5-ALA-induced red fluorescence was consistent with the EGFP fluorescent-positive nodules. Peritoneal dissemination was observed with conventional white light imaging in 8 patients. All nodules suspected as being peritoneal dissemination lesions by white light observation were similarly detected by ALA-induced fluorescence. In 1 patient, a small, flat lesion that was missed under white light observation was detected by ALA-induced fluorescence; the lesion was pathologically diagnosed as peritoneal metastasis. In the quantitative fluorescence image analysis, the red/(red + green + blue) ratio was higher in the metastatic nodules compared to the non-metastatic sites of the abdominal wall, fat and liver. We demonstrated better diagnostic accuracy using 5-ALA-PDD compared to conventional laparoscopy in patients with colorectal cancer. 5-ALA-PDD is a promising candidate method for diagnosing peritoneal dissemination of colorectal cancer.

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Section: Discussionmentioning

confidence: 99%

“…PpIX emits red fluorescence and peaks at 635 nm, with a blue-violet light excitation of 405 nm. Based on these mechanisms, 5-ALA has been used clinically as a photosensitizer in PDD in neurosurgery and urology (7–10). Previous reports on 5-ALA have demonstrated improved diagnostic performances in these fields.…”

Section: Introductionmentioning

confidence: 99%

Fluorescent detection of peritoneal metastasis in human colorectal cancer using 5-aminolevulinic acid

Kondo

Murayama

Konishi

et al. 2014

International Journal of Oncology

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“…Since the precancerous and cancerous cells have an increased uptake of ALA/MAL, PpIX fluorescence is significantly increased compared with normal surrounding skin. The clinical application and benefit of FD with ALA-induced porphyrins (FDAP) has proven useful for various cancer diagnoses in addition to the skin (e.g., oral malignancies [92], bladder tumors [93], cervical cancer [94] and lung cancer [95]). In dermatology, FDAP can be used as a useful tool to highlight initial skin tumors or even outline ill-defined tumor margins for biopsy or excisional surgery [96,97].…”

Section: Skin Cancer Diagnosis and Preventionmentioning

confidence: 99%

Recent advances in the prevention and treatment of skin cancer using photodynamic therapy

Zhao¹,

He²

2010

Expert Review of Anticancer Therapy

140

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Photodynamic therapy (PDT) is a noninvasive procedure that involves a photosensitizing drug and its subsequent activation by light to produce reactive oxygen species that specifically destroy target cells. Recently, PDT has been widely used in treating non-melanoma skin malignancies, the most common cancer in the USA, with superior cosmetic outcomes compared with conventional therapies. The topical 'photosensitizers' commonly used are 5-aminolevulinic acid (ALA) and its esterified derivative methyl 5-aminolevulinate, which are precursors of the endogenous photosensitizer protoporphyrin IX. After treatment with ALA or methyl 5-aminolevulinate, protoporphyrin IX preferentially accumulates in the lesion area of various skin diseases, which allows not only PDT treatment but also fluorescence diagnosis with ALA-induced porphyrins. Susceptible lesions include various forms of non-melanoma skin cancer such as actinic keratosis, basal cell carcinoma and squamous cell carcinoma. The most recent and promising developments in PDT include the discovery of new photosensitizers, the exploitation of new drug delivery systems and the combination of other modalities, which will all contribute to increasing PDT therapeutic efficacy and improving outcome. This article summarizes the main principles of PDT and its current clinical use in the management of non-melanoma skin cancers, as well as recent developments and possible future research directions.Keywords 5-aminolevulinic acid; ALA; MAL; methyl 5-aminolevulinate; PDT; photodynamic therapy; photosensitizers; skin cancer; topical PDT Skin cancer is the most common form of cancer, accounting for nearly half of all cancers in the USA [1]. The most common types of skin cancer are non-melanoma skin cancers (NMSCs): basal cell carcinoma (BCC), which forms in the basal cells, and squamous cell carcinoma (SCC), which forms in the squamous cells. BCCs are rarely fatal, but can be † Author for correspondence: Tel.: +1 773 795 4696, Fax: +1 773 702 8398, yyhe@medicine.bsd.uchicago.edu. Financial & competing interests disclosureWork in the authors' laboratories was supported by the American Skin Association, the University of Chicago Cancer Research Center (P30 CA014599), and the Intramural Research Program of the NIH, National Institute of Environmental Health Sciences. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. No writing assistance was utilized in the production of this manuscript. NIH Public Access Author ManuscriptExpert Rev Anticancer Ther. Author manuscript; available in PMC 2011 September 1. Genetic factors and environmental exposure to UV radiation in sunlight or tanning beds are strong risk factors for the genesis of skin cancer. Traditional skin c...

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“…Flat neoplastic lesions, such as dysplasia, carcinoma in situ or small papillary tumours of the bladder, are sometimes difficult to diagnose as they hide in normal, or unspecifically-inflamed mucosa. The use of fluorescence endoscopy has revealed a significantly higher detection rate of these lesions than with conventional white light alone [12].…”

Section: Current Clinical Applicationsmentioning

confidence: 99%

Blue light illumination for minimally-invasive fluorescence detection of tumours: technology, clinical experience and future perspectives

Gahlen

Prosst

Herfarth

2000

Minimally Invasive Therapy & Allied Technologies

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Endoscopic detection and differentiation of benign, precancerous and malignant tissue is difficult, especially in gastroenterology. Photodynamic techniques utilising tumour-specific fluorescence, e.g. induced by aminolevulinic acid (AM) / protoporphyrin IX (PplX), have been used to visualise and assess lesions. Originally requiring sophisticated laser technology, innovative excitation light sources have been recently developed for photodynamic diagnosis (PDD) to facilitate and broaden its clinical use. The characteristics of one of these devices, the D-Light (Karl Storz, Germany), are described. Current clinical applications and future perspectives of PDD are discussed.

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Detection of Early Bladder Cancer by 5-Aminolevulinic Acid Induced Porphyrin Fluorescence

Abstract: Due to the high sensitivity of the procedure fluorescence guided biopsies are recommended instead of random biopsies.

Cited by 365 publications

References 12 publications

Fluorescent detection of peritoneal metastasis in human colorectal cancer using 5-aminolevulinic acid

Fluorescent detection of peritoneal metastasis in human colorectal cancer using 5-aminolevulinic acid

Recent advances in the prevention and treatment of skin cancer using photodynamic therapy

Blue light illumination for minimally-invasive fluorescence detection of tumours: technology, clinical experience and future perspectives

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