Endoscopic photodynamic diagnosis: oral aminolevulinic acid is a marker of GI cancer and dysplastic lesions

Mayinger, Brigitte; H, Reh; Hochberger, J.; Hahn, Eckhart G.

doi:10.1016/s0016-5107(99)70232-4

Cited by 43 publications

(11 citation statements)

References 21 publications

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“…The potential for malignant degeneration of some chronic diseases like Barrett's oesophagus, ulcerative colitis and familial polyposis is well known. However, early cancers are difficult to diagnose, as they can hide in normal or unspecifically inflamed mucosa [37,38,39,40,41,42,43,44,45,46,47,48]. At present, assessment of endoscopic findings is subjectively made by the investigator.…”

Section: Discussion and Future Perspectivesmentioning

confidence: 99%

Fluorescence detection of small gastrointestinal tumours: principles, technique, first clinical experience

Orth

Russ

Steiner

et al. 2000

Langenbeck's Archives of Surgery

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Photodynamic therapy (PDT) is a form of cancer treatment based on the selective accumulation of a photosensitizer in neoplastic tissue. The fluorescent properties of a photosensitizer permit diagnostic localization of primary tumours and/or metastasis. Occult lesions are hard to detect and can easily be missed during routine laparoscopy. Fluorescence observation offers additional optical information and the ability to detect these occult tumours. Clinically, we used 5-aminolevulinic acid for peritoneal staining and tumour demarcation via tumour-specific fluorescence induced by protoporphyrin IX. For laparoscopic observations, a "D-Light" system was used; the conventional white light source was equipped with an optical blocking filter that transmits at the excitation wavelength (380-450 nm) and blocks all other parts of the spectrum. With the aid of a suitable observation filter, the relevant fluorescence was detectable. With the help of this fluorescence we increased the capacity to detect occult tumours, that were missed with white-light observation (9/26). In the gastrointestinal tract, we used a krypton laser at 405 nm for PP IX fluorescence induction. Although there were high sensitivity rates for neoplasms (81% peritoneal carcinomas, 60% gastric cancer), no exact histopathological statement could be achieved at because of false-positive fluorescence, mainly caused by inflammation (6/32). Current clinical goals and the future perspectives of photodynamic diagnostic are discussed.

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Section: Discussion and Future Perspectivesmentioning

confidence: 99%

Fluorescence detection of small gastrointestinal tumours: principles, technique, first clinical experience

Orth

Russ

Steiner

et al. 2000

Langenbeck's Archives of Surgery

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“…As porphyrins and metalloporphyrins (MP) have been used safely in the clinical arena for several years in tumour therapy [8], clinical imaging [9], treatment of porphyrias [10] and neonatal hyperbilrubinaemia in non-human primates [11], their development as a topical microbicide to prevent STI is logical.…”

Section: Introductionmentioning

confidence: 99%

Porphyrin-based compounds exert antibacterial action against the sexually transmitted pathogens Neisseria gonorrhoeae and Haemophilus ducreyi

Bozja

Shafer

et al. 2004

International Journal of Antimicrobial Agents

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“…ALA was first used in this manner in the upper gastrointestinal tract by Mayinger et al 42 . Four patients, all with different primary pathologies, were sensitized with 15 mg/kg ALA given orally.…”

Section: Ala‐photodetectionmentioning

confidence: 99%

5-Aminolaevulinic acid-induced photodynamic therapy and photodetection in Barrett’s esophagus

Claydon

Ackroyd

2004

Diseases of the Esophagus

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Barrett's esophagus is a precursor of adenocarcinoma of the esophagus. This cancer has the fastest growing incidence of any solid tumor in the Western world. Surveillance of Barrett's esophagus is routinely undertaken to detect early malignant transformation. However, ablative endoscopic treatments are available and these can obliterate the abnormal epithelium, allowing neosquamous regrowth. Photodynamic therapy using 5-aminolaevulinic acid (ALA) is such a technique. In this non-thermal method of ablation, ALA is metabolized to produce the photosensitizer protoprophyrin IX. This, together with light and oxygen, produces local tissue destruction. Fluorescence detection using ALA has also been used to identify areas of dysplasia and thus enhance positive biopsy yield. The use of ALA in photodynamic therapy and photodetection is reviewed.

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Endoscopic photodynamic diagnosis: oral aminolevulinic acid is a marker of GI cancer and dysplastic lesions

Cited by 43 publications

References 21 publications

Fluorescence detection of small gastrointestinal tumours: principles, technique, first clinical experience

Fluorescence detection of small gastrointestinal tumours: principles, technique, first clinical experience

Porphyrin-based compounds exert antibacterial action against the sexually transmitted pathogens Neisseria gonorrhoeae and Haemophilus ducreyi

5-Aminolaevulinic acid-induced photodynamic therapy and photodetection in Barrett’s esophagus

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