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CT-Guided Transgluteal Biopsy for Systematic Random Sampling of the Prostate in Patients Without Rectal Access
Ajit H Goenka1, Erick M Remer1,2, Joseph C Veniero1
11 Department of Radiology, Section of Abdominal Imaging, Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, A21, Cleveland, OH 44195.
AJR. American Journal of Roentgenology
|August 22, 2015
Summary
CT-guided transgluteal prostate biopsy offers a safe and effective alternative for prostate cancer diagnosis in patients lacking rectal access. Repeat biopsies are recommended for rising PSA levels after initial negative results.
Area of Science:
- Urology
- Radiology
- Oncology
Background:
- Prostate biopsy is crucial for diagnosing prostate cancer.
- Transrectal or transperineal approaches may be contraindicated in some patients.
- Alternative biopsy techniques are needed for patients without rectal access.
Purpose of the Study:
- To evaluate the safety and efficacy of CT-guided transgluteal prostate biopsy.
- To assess outcomes in patients unable to undergo standard biopsy methods.
Main Methods:
- 16 men underwent 21 CT-guided transgluteal prostate biopsies under conscious sedation.
- Patients had a mean age of 68 years and a mean PSA of 11.4 ng/mL.
- Six patients had prior unsuccessful biopsies via other routes.
Main Results:
- 95% of procedures were technically successful with minimal complications (one episode of hematuria and pain).
- 40% of successful biopsies yielded adenocarcinoma (mean Gleason score 8).
- No significant association was found between malignant results and PSA levels or core specimen numbers.
Conclusions:
- CT-guided transgluteal biopsy is a safe and reliable method for prostate sampling when rectal access is not feasible.
- Consider repeat biopsy for persistent PSA elevation after negative initial transgluteal biopsies.
