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

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.

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.

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).

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.