Transgluteal MRI-targeted biopsy versus transrectal systemic biopsy in prostate cancer diagnosis.

[OBJECTIVE] To compare the detection rate of clinically significant prostate cancer (csPCa) between transgluteal in-bore magnetic resonance imaging-targeted biopsy (MRI-TB) and transrectal ultrasonography biopsy (TRUSBx) in biopsy-naïve men, and which technique has lower complication rates.

[METHODS] From October 2021 to July 2024, clinical data were collected, retrospectively, from patients who underwent multiparameter MRI but had not previously undergone a prostate biopsy at hospital. The cases were considered based on the inclusion criteria. The patients were separated into two groups based on the prostate biopsy technique: TRUSBx (control group) and transgluteal MRI-TB (observation group). The csPCa detection and complications rates were compared between the two groups.

[RESULTS] We gathered data from 150 patients. A total of 91 patients participated, comprising 58 in the control group and 33 in the observation group. The detection rates of csPCa in the two groups were 27.3% and 22.4%, respectively (P > 0.05). Subsequent analysis revealed no significant difference in the csPCa detection rate between the two groups concerning various TPSA levels, lesion location, prostate volume, maximal lesion diameter, and PI-RADS score (P > 0.05). There were notable discrepancies in the occurrence of overall complications and hemorrhage between the two groups (P < 0.05), although no significant variations were observed in the incidence of fever, hematochezia, and dysuria (P > 0.05).

[CONCLUSION] Transgluteal MRI-TB can diminish complications while preserving csPCa detection rates. The evidence indicates that transgluteal MRI-TB is a more secure alternative for patients at elevated risk of infection and hemorrhage. And the pathway does not necessitate puncture tray or associated anesthetic management facilities.