A point-monitoring fluorescence diagnostic system based on a low-energ
y pulsed laser, fiber transmission optics, and an optical multichannel
analyzer was used for diagnosis of patients with bladder malignancies
. Twenty-four patients with bladder carcinoma, carcinoma in situ, and/
or dysplasia were injected with hematoporphyrin derivative, Photofrin,
0.35 or 0.5 mg/kg body weight, forty-eight hours prior to the investi
gation. The ratio between the red sensitizer emission and the bluish t
issue autofluorescence provided excellent demarcation between papillar
y tumors and normal bladder wall. Certain cases of dysplasia also coul
d be differentiated from normal mucosa. Benign exophytic lesions such
as malakoplakia appeared different from malignant tumors in fluorescen
ce. Flat suspicious bladder mucosa such as seen in infectious diseases
or after radiation therapy appeared normal on fluorescence.