I. Wang et al., Fluorescence diagnostics and kinetic studies in the head and neck region utilizing low-dose delta-aminolevulinic acid sensitization, CANCER LETT, 135(1), 1999, pp. 11-19
Diagnostic measurements and pharmacokinetic studies were performed in 17 pa
tients with various kinds of malignant, premalignant and benign lesions in
the head and neck region by means of point monitoring laser-induced fluores
cence. For marking different types of tissue, delta-aminolevulinic acid (AL
A)-induced protoporphyrin IX (PpIX) was used. The ALA-induced PpIX synthesi
s was monitored at different time intervals after oral administration of AL
A in low doses, 5 and 15 mg/kg b.w. Besides the porphyrin-related signal th
e tissue endogenous fluorescence was also recorded. The fluorescence spectr
a were evaluated at two different wavelengths corresponding to the specific
drug-related fluorescence peak and the endogenous tissue fluorescence emis
sion at 635 and 490 nm, respectively. The evaluated fluorescence data were
correlated to the histopathological tissue investigation. A fall-off in the
overall fluorescence intensity at 490 nm was obtained for an the malignant
and premalignant areas, as well as an increased red fluorescence. A ratio
between the red and the blue/green fluorescence intensity was formed for ea
ch time interval after the ALA administration. The lower drug dose seems to
be sufficient to obtain a useful demarcation ratio between normal and dise
ased tissue with a very low PpIX fluorescence intensity in the normal tissu
e. A PpIX fluorescence maximum seems to occur between 3 and 4 h in normal t
issues, whereas malignant tumour tissue shows a higher level for a longer p
eriod of time. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.