Abstract
BackgroundWe have developed a new diagnostic method using the photosensitizer 5-aminolevulinic acid (5ALA) for diagnosing intrathoracic malignant lesions. When ingested exogenously, 5ALA is metabolized to a heme precursor, protoporphyrin IX, which stays in malignant cells and emits red to pink luminescence of about 630 nm.MethodsWe enrolled 40 patients who underwent respiratory surgery and consented to participate in this study. Twenty-eight patients had primary lung cancer, 8 metastatic lung tumors, 2 malignant pleural tumors, and 2 benign tumors. Localization of malignant lesions was attempted by observing such lesions with an autofluorescence imaging system and by comparing the color tone of the autofluorescence between malignant lesions and normal tissues after oral administration of 5ALA. Malignant lesions on the pleural surface emitted pink autofluorescence in contrast to the green autofluorescence of the surrounding normal tissues.ResultsWhen 28 patients with primary lung cancer were examined according to the degree of pleural infiltration (pl), red fluorescence was confirmed in 10 of 10 patients (100%) with p11-p13 and 5 of 18 patients (27.7%) with p10. The latter 5 patients had been diagnosed with PL1 preoperatively or intraoperatively.ConclusionThis system achieved accurate localization of malignant lesions, suggesting that it may also be applicable to photodynamic therapy.
Highlights
We have developed a new diagnostic method using the photosensitizer 5-aminolevulinic acid (5ALA) for diagnosing intrathoracic malignant lesions
Diagnostic imaging techniques such as computed tomography, magnetic resonance imaging, and positron emission tomography (PET), as well as visual diagnosis during surgery, are of limited value for diagnosing early malignant pleural mesothelioma or minute intrathoracic dissemination that may contribute to intrathoracic recurrence after surgery for lung cancer
Exogenous 5ALA is ingested and metabolized to the heme precursor protoporphyrin IX, which stays in malignant cells and shows photogenesis, emitting red to pink fluorescence of about 630 nm [2]
Summary
We have developed a new diagnostic method using the photosensitizer 5-aminolevulinic acid (5ALA) for diagnosing intrathoracic malignant lesions. Diagnostic imaging techniques such as computed tomography, magnetic resonance imaging, and positron emission tomography (PET), as well as visual diagnosis during surgery, are of limited value for diagnosing early malignant pleural mesothelioma or minute intrathoracic dissemination that may contribute to intrathoracic recurrence after surgery for lung cancer. Exogenous 5ALA is ingested and metabolized to the heme precursor protoporphyrin IX, which stays in malignant cells and shows photogenesis, emitting red to pink fluorescence of about 630 nm [2] At present, this issue is studied in the fields of neurosurgery involving brain tumors [3] and urology involving bladder and prostate cancers [4,5], but there are no reports describing the use of this technique for intrathoracic malignant lesions. By comparing the color tone of autofluorescence between normal tissues and malignant lesions, we were able to devise a highly accurate method of localizing malignant lesions
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
