ALA-induced fluorescence in the canine oral cavity.

OBJECTIVE: We examined whether 5-aminolevulinic acid (ALA) could enhance the spectroscopic contrast between normal and diseased oral tissues, without prolonged photosensitivity. BACKGROUND DATA: ALA is a promising photosensitizing agent. METHODS: Adose of 25 mg/kg of ALA was administered intravenously to five dogs with gingivitis and three dogs with oral cancer, respectively. Fluorescence was recorded from the diseased sites in the oral cavity in addition to normal sites. RESULTS: ALA-induced proto-porphyrin IX fluorescence at all gingivitis sites reached a peak in 2-3 h and returned to baseline in 24 h. Fluorescence from the gingivitis site was observed earlier and was higher than the fluorescence from the normal site. For dogs with cancer, fluorescence from the cancerous sites occurred earlier in time compared to gingivitis sites and was comparatively higher in intensity. CONCLUSION: The fluorescence from the diseased sites was found to be higher than the normal site. Clinical and fluorescence data suggest that a dose of 25 mg/kg may be satisfactory for diagnostic purposes and would have minimal side effects.

Comparison of aminolevulinic-acid-induced fluorescence from normal and inflamed gingiva in the canine model.

Fluorescence spectroscopic detection using 5-amino levulinic acid (ALA) may provide an effective, noninvasive approach for early detection of oral cancer. In the present study, the use of ALA-induced fluorescence ratio (red/orange) to differentiate between normal and gingivitis-affected gingiva is investigated. Five dogs with varying degrees of gingivitis are studied. Based on previous studies, a dose of 25 mg/kg of ALA is administered intravenously to the dogs. Autofluorescence and ALA-induced fluorescence from three sites: normal gingiva, pigmented gingiva, and gingivitis, are detected with a fiber optic probe coupled to an optical multichannel analyzer. Four dogs show higher and earlier ALA-induced fluorescence from the gingivitis site as compared to the unpigmented gingiva. In two dogs, ALA-induced fluorescence peaks are seen 15 min after ALA administration. Statistical analysis using mean separation procedures reveal differences in the fluorescence from the various sites in each dog. Using a fluorescence (ratio) cutoff of 1.5, the sensitivity and specificity are found to be 92 and 80%, respectively, 1 h after administration of ALA. The indications from this study-that the characteristic protoporphyrin IX (PpIX) fluorescence is seen earlier and in higher magnitude in more vascular areas of the oral cavity-has implications for oral cancer diagnosis.