Photodynamic Diagnosis of Gastric Cancer Using 5-Aminolevulinic Acid

  • Tsutomu NamikawaEmail author
  • Keiji Inoue
  • Taro Shuin
  • Kazuhiro Hanazaki


5-Aminolevulinic acid (ALA) is a protoporphyrin IX precursor and a new-generation photosensitive substance for photodynamic diagnosis (PDD). Fluorescence navigation by PDD provides good visualization and detection of gastric cancer lesions, and might be particularly useful for intestinal type gastric cancer. PDD using ALA is a potentially valuable diagnostic tool for gastric cancer for evaluating both the surgical resection margins and extension of the lesion. Another promising application for this modality is in diagnosing peritoneal metastasis during preoperative staging laparoscopy wherein it could provide useful information for the selection of therapeutic modality.


Photodynamic diagnosis 5-Aminolevulinic acid Gastric cancer Protoporphyrin IX Adenocarcinoma Adenoma Endoscopy Endoscopic submucosal dissection Gastrectomy Photosensitizer 

Supplementary material

Video 20.1

Our ALA-PDD system revealed a slightly elevated lesion in this patient with a distinct margin demarcated by an intense fluorescent signal. This lesion was pathologically diagnosed as well-differentiated adenocarcinoma confined to the mucosal layer. (WMV 14365 kb)


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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Tsutomu Namikawa
    • 1
    Email author
  • Keiji Inoue
    • 2
  • Taro Shuin
    • 2
  • Kazuhiro Hanazaki
    • 1
  1. 1.Department of SurgeryKochi Medical SchoolNankokuJapan
  2. 2.Department of UrologyKochi Medical SchoolNankokuJapan

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