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Preoperative Pyuria as a Predictor of False-Positive Rates in the Photodynamic Diagnosis of Nonmuscle-Invasive Bladder Cancer Using Oral 5-Aminolevulinic Acid

  • 0Department of Urology, Kochi Medical School, Nankoku, Japan.
International Journal of Urology : Official Journal of the Japanese Urological Association +

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June 9, 2025

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June 9, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Preoperative pyuria, indicated by white blood cells in urine, may increase false positives in photodynamic diagnosis (PDD) for bladder cancer detection. However, pyuria does not impact PDD

Area Of Science

  • Urology
  • Oncology
  • Diagnostic Imaging

Background

  • Photodynamic diagnosis (PDD) using 5-aminolevulinic acid (ALA) is effective for detecting nonmuscle-invasive bladder cancer.
  • Inflammation, indicated by pyuria, is a known cause of false-positive PDD results.
  • The impact of preoperative pyuria on PDD diagnostic accuracy remains unclear.

Purpose Of The Study

  • To investigate the influence of preoperative pyuria on the diagnostic accuracy of PDD for nonmuscle-invasive bladder cancer.
  • To determine if pyuria affects the sensitivity and specificity of PDD.
  • To assess pyuria as a predictor of false-positive PDD results.

Main Methods

  • Retrospective analysis of 101 patients undergoing PDD-assisted transurethral resection of bladder tumors.
  • Patients were categorized into two groups: with and without preoperative pyuria.
  • Diagnostic accuracy metrics (sensitivity, specificity, PPV, NPV) were compared between groups.

Main Results

  • The pyuria group exhibited lower specificity (45.6%) compared to the no pyuria group (64.1%).
  • This indicates a significantly higher false-positive rate in patients with preoperative pyuria.
  • Sensitivity, positive predictive value, and negative predictive value were comparable between groups.

Conclusions

  • Preoperative pyuria does not significantly alter PDD's ability to detect bladder cancer.
  • Pyuria is associated with an increased false-positive rate in PDD.
  • Preoperative pyuria serves as a useful predictor for false-positive PDD results.

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