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Photodynamic Diagnosis Mediated by 5-Aminolevulinic Acid for Urinary Bladder Cancer

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Fluorescence Imaging for Surgeons

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Abstract

5-Aminolevulinic acid (ALA) is an endogenous natural amino acid, and has recently been attracting attention as a new-generation photosensitive substance for photodynamic diagnosis (PDD). In the urology field, ALA-mediated PDD (ALA-PDD) has already been approved for the intraoperative diagnosis of non-muscle invasive bladder cancer (NMIBC) as a novel fluorescence-guided navigation technology approved in Europe and United States, whereas in Japan, ALA is waiting for approval as a photosensitizer for bladder cancer. Moreover, ALA-PDD is also clinically applied for the diagnosis of upper urinary tract cancer, prostate cancer, and renal cancer. This chapter outlines ALA-PDD for urinary bladder cancer.

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Author information

Authors and Affiliations

  1. Department of Urology, Kochi Medical School, Kohasu, Oko, Nankoku, Kochi, 783-8505, Japan

    Keiji Inoue M.D., Ph.D., Hideo Fukuhara M.D., Ph.D. & Taro Shuin M.D., Ph.D.

Authors
  1. Keiji Inoue M.D., Ph.D.
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  2. Hideo Fukuhara M.D., Ph.D.
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  3. Taro Shuin M.D., Ph.D.
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Corresponding author

Correspondence to Keiji Inoue M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Section of Minimally Invasive Surgery, Department of General and Vascular Surgery, The Bariatric and Metabolic Institute, Cleveland Clinic Florida, FL, USA; Oncological Surgical Division, Division of Surgical Research, Department of Surgery, Hospital de Clinicas Buenos Aires, University of Buenos Aires, Buenos Aires, Argentina

    Fernando D. Dip

  2. Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research; Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

    Takeaki Ishizawa

  3. Hepato-Biliary-Pancreatic Surgery; Department of Surgery, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan

    Norihiro Kokudo

  4. Department of General Surgery, Section of Minimally Invasive Surgery; Department of General and Vascular Surgery, The Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida, USA

    Raul J. Rosenthal

Electronic Supplementary Material

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There were multiple papillary tumors. ALA-PDD could show red fluorescence of these tumors themselves and also the outskirts of these tumors. In particular, a tiny and flat lesion could be detected only by ALA-PDD in the right posterior wall of urinary bladder. Moreover, the floating of a lot of bladder cancer cells with PDD-fluorescence (MP4 87,401 kb) could be detected.

In TURB, bladder tumor is scraped with the looped type of electrical scalpel under the cystoscopic observation. TURB under ALA-PDD enable to confirm the correct surgical margin by navigation of red fluorescence. The residual lesions with red fluorescence at the resected margin could be resected additionally and exactly (MP4 201,878 kb)

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Inoue, K., Fukuhara, H., Shuin, T. (2015). Photodynamic Diagnosis Mediated by 5-Aminolevulinic Acid for Urinary Bladder Cancer. In: Dip, F., Ishizawa, T., Kokudo, N., Rosenthal, R. (eds) Fluorescence Imaging for Surgeons. Springer, Cham. https://doi.org/10.1007/978-3-319-15678-1_30

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  • DOI: https://doi.org/10.1007/978-3-319-15678-1_30

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-15677-4

  • Online ISBN: 978-3-319-15678-1

  • eBook Packages: MedicineMedicine (R0)

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