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Comparison between 5-aminolevulinic acid photodynamic diagnosis and narrow-band imaging for bladder cancer detection

Authors
  • Hagimoto, Hiroki1
  • Makita, Noriyuki1
  • Mine, Yuta1
  • Kokubun, Hidetoshi1
  • Murata, Shiori1
  • Abe, Yohei1
  • Kubota, Masashi1
  • Tsutsumi, Naofumi1
  • Yamasaki, Toshinari1
  • Kawakita, Mutsushi1
  • 1 Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan , Kobe (Japan)
Type
Published Article
Journal
BMC Urology
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Dec 22, 2021
Volume
21
Issue
1
Identifiers
DOI: 10.1186/s12894-021-00946-w
Source
Springer Nature
Keywords
Disciplines
  • Research
License
Green

Abstract

BackgroundTo compare 5-aminolevulinic acid (5-ALA)-mediated photodynamic diagnosis (PDD) with narrow-band imaging (NBI) for cancer detection during transurethral resection of bladder tumour (TURBT).MethodsBetween June 2018 and October 2020, 114 patients and 282 lesions were included in the analysis. Patients were orally administered 5-ALA (20 mg/kg) 2 h before TURBT. The bladder was inspected with white light (WL), PDD, and NBI for each patient, and all areas positive by at least one method were resected or biopsied. The imaging data were then compared to the pathology results.ResultsThe sensitivities of WL, PDD, and NBI for detecting urothelial carcinoma were 88.1%, 89.6%, and 76.2%, respectively. The specificity, positive predictive value, and negative predictive value for detecting urothelial carcinoma were 47.5%, 80.9%, and 61.3%, respectively, for WL; 22.5%, 74.5%, and 46.2%, respectively, for PDD; and 46.3%, 78.2%, and 43.5%, respectively, for NBI. PDD was significantly more sensitive than NBI for all lesions (p < 0.001) and carcinoma in situ (CIS) 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%. Therefore, 100% of CIS lesions can be detected by adding PDD to WL.

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