alexa Accuracy of photodynamic diagnosis in the detection and follow-up of patients with upper urinary tract lesions: Initial 3-year experience.


Medical & Surgical Urology

Author(s): Aboumarzouk OM, Ahmad S, Moseley H, Kata SG, Aboumarzouk OM, Ahmad S, Moseley H, Kata SG

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Abstract OBJECTIVE: To assess the diagnostic accuracy of photodynamic diagnostic (PDD) ureterorenoscopy for detecting upper-urinary tract transitional cell carcinoma (UUT-TCC) in our initial 3 years, and compare the results with that of white light ureterorenoscopy (WLU). PATIENTS AND METHODS: Between August 2007 and March 2010, 32 patients underwent PDD flexible ureterorenoscopy for UUT-TCC. Oral 5-aminolaevulinic acid (5-ALA) was used as the photosensitiser. The sensitivity, specificity and detection rate of PDD were calculated. RESULTS: The sensitivity, specificity, positive and negative predictive values of PDD for detecting abnormal tissue were 96\%, 100\%, 100\% and 88\%, compared to the results of WLU of 80\%, 86\%, 95\% and 55\%, respectively. PDD was able to detect 96\% (24/25) of the abnormal tissue and 96\% (21/22) of cancerous tissue, while WLU detected 80\% (20/25) of abnormal tissue and 91\% (20/22) of the tumour tissue. Three patients of the 32 (10\%) developed side-effects related to 5-ALA; two patients developed a facial-skin photosensitive reaction and one developed hypotension. All were treated conservatively, with no long-term effects. CONCLUSION: PDD can be used safely in the UUT, and with a higher sensitivity, specificity and detection rate than standard WLU for detecting UUT tumours.
This article was published in Arab J Urol and referenced in Medical & Surgical Urology

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