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Photodynamic diagnosis of pleural malignant lesions with a combination of 5-aminolevulinic acid and intrinsic fluorescence observation systems.

Kitada M, Ohsaki Y, Matsuda Y, Hayashi S, Ishibashi K - BMC Cancer (2015)

Bottom Line: Malignant lesions on the pleural surface emitted pink autofluorescence in contrast to the green autofluorescence of the surrounding normal tissues.The latter 5 patients had been diagnosed with PL1 preoperatively or intraoperatively.This system achieved accurate localization of malignant lesions, suggesting that it may also be applicable to photodynamic therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Respiratory Center, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan. k1111@asahikawa-med.ac.jp.

ABSTRACT

Background: We 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.

Methods: We 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.

Results: When 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.

Conclusion: This system achieved accurate localization of malignant lesions, suggesting that it may also be applicable to photodynamic therapy.

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Related in: MedlinePlus

Metastatic pulmonary tumor from renal cell carcinoma. The tumor, although very small, emits red light, whereas normal tissue shows green autofluorescence.
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Fig6: Metastatic pulmonary tumor from renal cell carcinoma. The tumor, although very small, emits red light, whereas normal tissue shows green autofluorescence.

Mentions: Lesions not distinguishable with white light could be visualized employing the autofluorescence camera; the well-defined tumor site was visualized as a pink mass in contrast to the green autofluorescence emitted by the surrounding normal tissues. Clearly demarcated lung cancer with p12 pleural invasion is shown in Figure 4. Pleural malignant mesothelioma with red to pink autofluorescence is shown in Figure 5. Metastatic lung tumors were also visualized similarly in all patients (Figure 6). Another disseminated lesion detected employing this system is shown in Figure 7. In this patient undergoing surgery based on the preoperative diagnosis of T2N0, the area of pleural dissemination was seen as red fluorescence, whereas there was no change in the color of the thickened part of the fibrous pleura.Figure 4


Photodynamic diagnosis of pleural malignant lesions with a combination of 5-aminolevulinic acid and intrinsic fluorescence observation systems.

Kitada M, Ohsaki Y, Matsuda Y, Hayashi S, Ishibashi K - BMC Cancer (2015)

Metastatic pulmonary tumor from renal cell carcinoma. The tumor, although very small, emits red light, whereas normal tissue shows green autofluorescence.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4374504&req=5

Fig6: Metastatic pulmonary tumor from renal cell carcinoma. The tumor, although very small, emits red light, whereas normal tissue shows green autofluorescence.
Mentions: Lesions not distinguishable with white light could be visualized employing the autofluorescence camera; the well-defined tumor site was visualized as a pink mass in contrast to the green autofluorescence emitted by the surrounding normal tissues. Clearly demarcated lung cancer with p12 pleural invasion is shown in Figure 4. Pleural malignant mesothelioma with red to pink autofluorescence is shown in Figure 5. Metastatic lung tumors were also visualized similarly in all patients (Figure 6). Another disseminated lesion detected employing this system is shown in Figure 7. In this patient undergoing surgery based on the preoperative diagnosis of T2N0, the area of pleural dissemination was seen as red fluorescence, whereas there was no change in the color of the thickened part of the fibrous pleura.Figure 4

Bottom Line: Malignant lesions on the pleural surface emitted pink autofluorescence in contrast to the green autofluorescence of the surrounding normal tissues.The latter 5 patients had been diagnosed with PL1 preoperatively or intraoperatively.This system achieved accurate localization of malignant lesions, suggesting that it may also be applicable to photodynamic therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Respiratory Center, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan. k1111@asahikawa-med.ac.jp.

ABSTRACT

Background: We 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.

Methods: We 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.

Results: When 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.

Conclusion: This system achieved accurate localization of malignant lesions, suggesting that it may also be applicable to photodynamic therapy.

Show MeSH
Related in: MedlinePlus