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Title: Role of photodynamic diagnosis in detection of upper urinary tract urothelial carcinoma
Abstract:
Initial diagnosis of upper urinary tract urothelial carcinoma relies on imaging which is not sufficient to detect flat lesions, like dysplasia, carcinoma in situ or tiny multifocal tumours. All patients require direct endoscopic visualisation with or without biopsy. The aim is to evaluate the usefulness of photodynamic diagnosis in comparison with standard white light in the detection of upper urinary tract transitional cell cancer, with a focus on lesions difficult to visualize (dysplasia and carcinoma in situ) and in the detection of concomitant lower urinary carcinoma. Sensitivity, specificity, positive and negative predictive value were 53.5%, 95.2%, 88.5%, 75% for white light and 95.8%, 96.6%, 95.8%, 96.6% for photodynamic diagnostic ureterorenoscopy. Diagnostic accuracy was 78% and 98% respectively. Photodynamic diagnostic ureterorenoscopy depicted 93.75% carcinoma in situ/dysplasia lesions, while standard revealed 18.75% only. Simultaneous photodynamic diagnostic endoscopy of upper and lower urinary tract depicted 92.3% of carcinoma in situ bladder lesions compared to 7.6% for the white light. Photosensitiser specific complications were observed in 19.3% and all were Clavien I. The analysis confirms superiority of photodynamic diagnostic ureterorenoscopy over the white light in detection of flat urothelial lesions in the upper urinary tract as well as white light’s inabi ; lity to detect carcinoma in situ in the upper and lower urinary tract. Oral administration of the photosensitizer allows simultaneous blue light inspection of the bladder and the upper urinary tract.
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Chłosta, Piotr ; Gołąbek, Tomasz
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Last modified:
Mar 17, 2023
In our library since:
Oct 30, 2017
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9
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http://dl.cm-uj.krakow.pl:8080/publication/4192
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| Edition name | Date |
|---|---|
| ZB-127024 | Mar 17, 2023 |
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