PDD-URS and PDD-TURBT: Comparable Diagnostic Results in BUC & UTUC

Takeshi Sano and the team aimed to compare the diagnostic performance of photodynamic diagnosis (PDD) with oral 5-aminolaevulinic acid in suspected upper tract urothelial carcinoma (UTUC) and bladder urothelial carcinoma (BUC) cases.

This retrospective study included 18 suspected patients with UTUC who underwent ureteroscopy with oral 5-ALA in the PDD-URS cohort from June 2018 to January 2019, and 110 suspected patients with BUC who underwent transurethral resection of bladder tumor in the PDD- transurethral resection of bladder tumour(TURBT) cohort from January 2019 to March 2023.

Researchers collected 63 during URS, and 708 samples during TURBT. The diagnostic accuracy of white light and PDD in both cohorts was evaluated, and false PDD-positive samples were pathologically re-evaluated.

The results revealed that the area under the receiver operating characteristic curve (AUC) of PDD was significantly superior to that of WL in both cohorts. The per-biopsy sensitivity, specificity, and positive and negative predictive values of PDD in the PDD-URS and PDD-TURBT cohorts were 91.2% vs. 71.4%, 75.9% vs. 75.3%, 81.6% vs. 66.3%, and 88.0% vs. 79.4%, respectively.

The PDD-URS cohort exhibited a higher AUC than the PDD-TURBT cohort (0.84 vs. 0.73). Seven of 12 false PDD-positive samples (57.1%) in the PDD-URS cohort showed potential precancerous findings compared with eight of 101 (7.9%) in the PDD-TURBT cohort.

The diagnostic performance of PDD in the PDD-URS cohort was at least equivalent to that in the PDD-TURBT cohort.

No funding information was given.

Source: https://pubmed.ncbi.nlm.nih.gov/38985343/

Sano T, Yoshida T, Nakamoto T, et al. (2024). “Diagnostic performance of photodynamic diagnosis with oral 5-aminolevulinic acid for upper tract- and bladder urothelial carcinoma: a single-centre, retrospective analysis.” World J Urol. 2024;42(1):389. Published 2024 Jul 10. doi:10.1007/s00345-024-05083-1