Photodynamic diagnostic ureterorenoscopy: a valuable tool in the detection of upper urinary tract tumour
Photodynamic diagnostic ureterorenoscopy: a valuable tool in the detection of upper urinary tract tumour
Background: photodynamic
diagnosis increases the detection rate and hence decreases recurrence
rates of urothelial cancer (UC) of the bladder. This technique has been
implemented in the upper urinary tract and like in the bladder, has
shown to increase the detection rate of urothelial lesions.Objectives: to
determine the sensitivity, specificity, and detection rates for
photodynamic diagnostic flexible ureterorenoscopy (PDD-FURS) and white
light ureterorenoscopy (WL-FURS).
Design: between 2009 and 2013, PDD-FURS was performed within 106 Upper urinary
tract (UUT) Units (Mean age—72.6 ± 9.5). Indications for the procedure
included abnormal upper urinary tract on imaging, normal flexible
cystoscopy with abnormal urine cytology, endoscopic treatment and
follow-up of UUT UC. Oral 5-aminolevulinic acid was used as the
photosensitizer administered 3-4 h pre-operatively.
Results: 48 lesions were detected, of which 95.8% (46/48) where visualised by PDD-FURS compared to 47.9% (23/48) shown by WL-FURS (
P < 0.0001).
PDD-FURS detected significantly more carcinoma in situ (CIS) or
dysplasia lesions than WL-FURS (93.75% (15/16) vs. 18.75% (3/16),
respectively, (
P = 0.0006)). Furthermore, PDD-FURS detected significantly more UC lesions than WL-FURS (96.9% (31/32) vs. 62.5% (20/32) (
P = 0.007)).
PDD-FURS was more sensitive (95.8; range: 85.7–99.5) than WL-FURS (53.5; range: 37.7–68.8) in detecting UUT-UC (P < 0.0001). There was no difference (P = 0.716) in the specificity between PDD-FURS (96.6; range: 88.1–99.6) and WL-FURS (95.2; range: 86.7–99).
Conclusions: our
results PDD-FURS with oral 5-ALA as photosensitizer suggest higher
sensitivity and detection rate of urothelial tumours than WL-FURS, with a
good safety profile. In our series, PDD-FURS enhanced the visualisation
of flat lesions, such as CIS and dysplasia that otherwise would have
been missed.
Administration, Oral, Aminolevulinic Acid, Image Enhancement, Kidney Neoplasms, Photosensitizing Agents, Reproducibility of Results, Sensitivity and Specificity, Ureteroscopy, Urethral Neoplasms, Journal Article
255-260
Kata, Slawomir G
bb011d0d-01f0-4c99-ac40-e8db8d4ef4d0
Aboumarzouk, Omar M
3c7e2433-638d-4378-9931-902fdc68acce
Zreik, Abdullah
d3bd6be1-c5a4-4e78-aaaa-62160c502047
Somani, Bhaskar
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Ahmad, Sarfraz
b8a17e16-b4d2-40ed-a502-081ec868f928
Nabi, Ghulam
20d3e635-ec9c-4b53-8703-f50b443196da
Buist, Ronald
d83f6881-cb69-435c-899c-b349d57c77a9
Goodman, Carol
9fada409-be5d-4d5b-8a38-6a70d3710144
Chlosta, Piotr
922ceecf-17a8-49ca-b484-8c0b5d03e70e
Golabek, Tomasz
2aa2f021-dad4-432a-84fa-c10b76117908
Moseley, Harry
d4113f63-0303-4a8b-835e-f32ebe706dd2
March 2016
Kata, Slawomir G
bb011d0d-01f0-4c99-ac40-e8db8d4ef4d0
Aboumarzouk, Omar M
3c7e2433-638d-4378-9931-902fdc68acce
Zreik, Abdullah
d3bd6be1-c5a4-4e78-aaaa-62160c502047
Somani, Bhaskar
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Ahmad, Sarfraz
b8a17e16-b4d2-40ed-a502-081ec868f928
Nabi, Ghulam
20d3e635-ec9c-4b53-8703-f50b443196da
Buist, Ronald
d83f6881-cb69-435c-899c-b349d57c77a9
Goodman, Carol
9fada409-be5d-4d5b-8a38-6a70d3710144
Chlosta, Piotr
922ceecf-17a8-49ca-b484-8c0b5d03e70e
Golabek, Tomasz
2aa2f021-dad4-432a-84fa-c10b76117908
Moseley, Harry
d4113f63-0303-4a8b-835e-f32ebe706dd2
Kata, Slawomir G, Aboumarzouk, Omar M, Zreik, Abdullah, Somani, Bhaskar, Ahmad, Sarfraz, Nabi, Ghulam, Buist, Ronald, Goodman, Carol, Chlosta, Piotr, Golabek, Tomasz and Moseley, Harry
(2016)
Photodynamic diagnostic ureterorenoscopy: a valuable tool in the detection of upper urinary tract tumour.
Photodiagnosis and photodynamic therapy, 13, .
(doi:10.1016/j.pdpdt.2015.08.002).
Abstract
Background: photodynamic
diagnosis increases the detection rate and hence decreases recurrence
rates of urothelial cancer (UC) of the bladder. This technique has been
implemented in the upper urinary tract and like in the bladder, has
shown to increase the detection rate of urothelial lesions.Objectives: to
determine the sensitivity, specificity, and detection rates for
photodynamic diagnostic flexible ureterorenoscopy (PDD-FURS) and white
light ureterorenoscopy (WL-FURS).
Design: between 2009 and 2013, PDD-FURS was performed within 106 Upper urinary
tract (UUT) Units (Mean age—72.6 ± 9.5). Indications for the procedure
included abnormal upper urinary tract on imaging, normal flexible
cystoscopy with abnormal urine cytology, endoscopic treatment and
follow-up of UUT UC. Oral 5-aminolevulinic acid was used as the
photosensitizer administered 3-4 h pre-operatively.
Results: 48 lesions were detected, of which 95.8% (46/48) where visualised by PDD-FURS compared to 47.9% (23/48) shown by WL-FURS (
P < 0.0001).
PDD-FURS detected significantly more carcinoma in situ (CIS) or
dysplasia lesions than WL-FURS (93.75% (15/16) vs. 18.75% (3/16),
respectively, (
P = 0.0006)). Furthermore, PDD-FURS detected significantly more UC lesions than WL-FURS (96.9% (31/32) vs. 62.5% (20/32) (
P = 0.007)).
PDD-FURS was more sensitive (95.8; range: 85.7–99.5) than WL-FURS (53.5; range: 37.7–68.8) in detecting UUT-UC (P < 0.0001). There was no difference (P = 0.716) in the specificity between PDD-FURS (96.6; range: 88.1–99.6) and WL-FURS (95.2; range: 86.7–99).
Conclusions: our
results PDD-FURS with oral 5-ALA as photosensitizer suggest higher
sensitivity and detection rate of urothelial tumours than WL-FURS, with a
good safety profile. In our series, PDD-FURS enhanced the visualisation
of flat lesions, such as CIS and dysplasia that otherwise would have
been missed.
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More information
Published date: March 2016
Keywords:
Administration, Oral, Aminolevulinic Acid, Image Enhancement, Kidney Neoplasms, Photosensitizing Agents, Reproducibility of Results, Sensitivity and Specificity, Ureteroscopy, Urethral Neoplasms, Journal Article
Identifiers
Local EPrints ID: 419243
URI: http://eprints.soton.ac.uk/id/eprint/419243
ISSN: 1572-1000
PURE UUID: b985bd00-0a34-4ac4-bd86-90ea2265cb68
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Date deposited: 09 Apr 2018 16:30
Last modified: 15 Mar 2024 19:02
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Contributors
Author:
Slawomir G Kata
Author:
Omar M Aboumarzouk
Author:
Abdullah Zreik
Author:
Sarfraz Ahmad
Author:
Ghulam Nabi
Author:
Ronald Buist
Author:
Carol Goodman
Author:
Piotr Chlosta
Author:
Tomasz Golabek
Author:
Harry Moseley
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