{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T04:54:03Z","timestamp":1776920043074,"version":"3.51.2"},"reference-count":23,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T00:00:00Z","timestamp":1722556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Photodynamic diagnosis (PDD)\u2010assisted transurethral resection of bladder tumors (TURBT) has emerged as a promising complementary tool to white light (WL) cystoscopy, potentially improving cancer detection and replacing conventional mapping biopsies. This study aimed to investigate the diagnostic accuracy of PDD by anatomical locations in mapping biopsies through lesion\u2010based analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PDD and WL findings were prospectively recorded in 102 patients undergoing mapping biopsies and PDD\u2010assisted TURBT using oral 5\u2010aminolevulinic acid. We evaluated 673 specimens collected from flat tumor or normal\u2010looking lesions on WL cystoscopy, after excluding 98 specimens collected from papillary or nodular tumors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 673 lesions, cancer was detected in 110 (16%) by lesion\u2010based analysis. PDD demonstrated significantly higher sensitivity (65.5% vs. 46.4%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and negative predictive value (92.5% vs. 89.5%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) compared to WL. The sensitivity of PDD findings varied by location: posterior (100%), right (78.6%), dome (73.3%), left (70.6%), trigone (58.8%), bladder neck (41.7%), anterior (40.0%), and prostatic urethra (25.0%). Incorporating targeted biopsies of specific locations (bladder neck, anterior, and prostatic urethra) into the PDD\u2010guided biopsies, regardless of PDD findings, significantly increased the overall sensitivity from 65.5% to 82.7% (<jats:italic>p<\/jats:italic>\u2009=\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study first demonstrated the detection rate of location\u2010specific mapping biopsies using PDD, revealing difficulties in accuracy assessment in areas susceptible to tangential fluorescence. While PDD\u2010guided biopsy improves cancer detection compared to WL cystoscopy even for flat tumors or normal\u2010looking lesions, more careful decisions, including mapping biopsies, may be beneficial for an assessment in these tangential areas.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iju.15552","type":"journal-article","created":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T07:39:12Z","timestamp":1722584352000},"page":"1263-1268","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Location\u2010specific diagnostic efficiency of photodynamic diagnosis\u2010guided biopsy in bladder mapping biopsies"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4931-2489","authenticated-orcid":false,"given":"Yuki","family":"Nakamura","sequence":"first","affiliation":[{"name":"Department of Urology Tokyo Medical and Dental University  Bunkyo\u2010ku Tokyo 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