In vivo local fluorescence spectroscopy in PDD of superficial bladder cancer

  • Bulgakova N
  • Ulijanov R
  • Vereschagin K
 et al. 
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Abstract

Objective: A combination of fluorescence imaging with in vivo local fluorescence spectroscopy (LFS) was used to improve the predictive ability of photodynamic diagnosis (PDD) of superficial bladder cancer after intravesical instillation of Alasense, a 5-aminolevulinic acid (5-ALA)-based agent. Material and method: A total of 62 patients with superficial malignancies of the urinary bladder were included in a preliminary clinical study. Nineteen patients underwent autofluorescence (AF) examination, whereas 43 patients underwent photodynamic diagnosis (PDD) after intravesical instillation of Alasense (NIOPIK, Russia). After visual examination of the urinary bladder wall under white and blue light, fluorescence emission spectra were recorded in vivo under 442 and 532 nm laser excitation within visible red fluorescent zones that had been preliminarily revealed by fluorescence imaging. For spectral data interpretation, a spectral fluorescence parameter was introduced as a ratio of the 5-ALA-induced protoporphyrin IX-emission intensity to that of the AF emission. In the search for a quantitative criterion for this parameter, as well as a diagnostic algorithm to facilitate differentiation between inflammatory and neoplastic tissues, two approaches were tested based on: (1) a posteriori estimation of the threshold values of the spectral fluorescence parameters for inflammation and cancerous tissues, and (2) a posteriori probability of attributing an acquired emission spectrum to a histologically confirmed tissue type. Results: In the group of patients without intravesical instillation of Alasense (n=19), LFS showed a dramatic drop (with a factor of 5-20, p

Author-supplied keywords

  • 5-ALA
  • Autofluorescence
  • Fluorescence spectroscopy
  • Laser-induced fluorescence
  • Protoporphyrin IX
  • Superficial bladder cancer

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Authors

  • Natalia Bulgakova

  • Roman Ulijanov

  • Konstantin Vereschagin

  • Victor Sokolov

  • Alexander Teplov

  • Igor Rusakov

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