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Fluorescence hysteroscopy using 5-aminolevulinic: a descriptive study


Wyss, Pius; Degen Iseli, Andrea Franziska; Caduff, Rosmarie; Hornung, Rene; Haller, Urs; Fehr, Mathias (2003). Fluorescence hysteroscopy using 5-aminolevulinic: a descriptive study. Lasers in surgery and medicine, 33(3):209-212.

Abstract

BACKGROUND AND OBJECTIVES To assess the feasibility of fluorescence hysteroscopy following topical ALA application and to describe the optical appearance of normal and neoplastic endometrium.
STUDY DESIGN/MATERIALS AND METHODS Fifty-four patients scheduled for routine hysteroscopy and D&C were assigned to the study group using topically applied ALA. Two milliliters of a 2% 5-ALA-solution at pH = 4.0 (ASAT AG/Zug, Switzerland) was administrated into the uterine cavity 4 hours before fluorescence hysteroscopy, using a STORZ-D-Light (Tuttlingen, Germany) system. Hysteroscopic findings were compared to the histological diagnosis of hematoxylin & eosin (H&E) stained sections. In the study group, 60 histological specimens were taken (47 materials of curettage and 13 targeted biopsies). The percentage of fluorescence positive patients was calculated.
RESULTS The rate of fluorescent endometrial samples was low in atrophic endometrium 1/16 (6.2%). Endometrial carcinoma were diagnosed in two patients. Both cases exhibited selective and intense PpIX-mediated red fluorescence. Fluorescence hysteroscopy could not differentiate between hyperplastic areas with or without atypia. Minimal uterine cramps or discomfort following ALA instillation were complained by 30 (56%) patients, no pain was indicated by 24 patients (44%).
CONCLUSIONS Fluorescence hysteroscopy following intrauterine application of ALA is feasible. Cancerous, hyperplastic, and secretory endometrial tissue showed high red fluorescence.

Abstract

BACKGROUND AND OBJECTIVES To assess the feasibility of fluorescence hysteroscopy following topical ALA application and to describe the optical appearance of normal and neoplastic endometrium.
STUDY DESIGN/MATERIALS AND METHODS Fifty-four patients scheduled for routine hysteroscopy and D&C were assigned to the study group using topically applied ALA. Two milliliters of a 2% 5-ALA-solution at pH = 4.0 (ASAT AG/Zug, Switzerland) was administrated into the uterine cavity 4 hours before fluorescence hysteroscopy, using a STORZ-D-Light (Tuttlingen, Germany) system. Hysteroscopic findings were compared to the histological diagnosis of hematoxylin & eosin (H&E) stained sections. In the study group, 60 histological specimens were taken (47 materials of curettage and 13 targeted biopsies). The percentage of fluorescence positive patients was calculated.
RESULTS The rate of fluorescent endometrial samples was low in atrophic endometrium 1/16 (6.2%). Endometrial carcinoma were diagnosed in two patients. Both cases exhibited selective and intense PpIX-mediated red fluorescence. Fluorescence hysteroscopy could not differentiate between hyperplastic areas with or without atypia. Minimal uterine cramps or discomfort following ALA instillation were complained by 30 (56%) patients, no pain was indicated by 24 patients (44%).
CONCLUSIONS Fluorescence hysteroscopy following intrauterine application of ALA is feasible. Cancerous, hyperplastic, and secretory endometrial tissue showed high red fluorescence.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Gynecology
Dewey Decimal Classification:340 Law
Language:English
Date:2003
Deposited On:30 Jan 2017 10:16
Last Modified:30 Jan 2017 10:16
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:0196-8092
Funders:KTI
Publisher DOI:https://doi.org/10.1002/lsm.10210
PubMed ID:12949952

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