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Hexaminolevulinate is an optical imaging agent and ester of aminolevulinic acid, used as a diagnostic drug in the detection of non-muscle invasive bladder cancer (NMIBC), including papillary tumors and carcinoma in situ. Administered intravesically, it enters the bladder mucosa where it is metabolized to protoporphyrin IX (PpIX) and other photoactive porphyrins. These compounds preferentially accumulate in neoplastic or inflamed cells due to altered enzymatic activity. Upon illumination with blue light (360–450 nm), PpIX fluoresces red, allowing for enhanced visualization of malignant lesions during cystoscopy using photodynamic diagnostic systems. This fluorescence-based contrast helps distinguish tumor tissue from normal urothelium[1][2][3][10].
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