3.0-T MR-guided transgluteal in-bore-targeted prostate biopsy under local anesthesia in patients without rectal access: a single-institute experience and review of literature.

Purpose: To describe the technique and evaluate the performance of MRI-guided transgluteal in-bore-targeted biopsy of the prostate gland under local anesthesia in patients without rectal access. Methods: Ten men (mean age, 69 (range 57–86) years) without rectal access underwent 13 MRI-guided transgl...

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Publicado en:Abdominal Radiology Vol. 49; no. 4; pp. 1223 - 1231
Autores principales: Bera, Kaustav, Ramaiya, Nikhil, Paspulati, Raj Mohan, Nakamoto, Dean, Tirumani, Sree Harsha
Formato: Journal Article
Publicado: Springer Nature Apr2024
Acceso en línea:Ver este registro en EBSCOhost
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        atl: 3.0-T MR-guided transgluteal in-bore-targeted prostate biopsy under local anesthesia in patients without rectal access: a single-institute experience and review of literature.
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        au:
          Bera, Kaustav
          Ramaiya, Nikhil
          Paspulati, Raj Mohan
          Nakamoto, Dean
          Tirumani, Sree Harsha
        affil: Department of Radiology, University Hospitals Cleveland Medical Center, 44106, Cleveland, OH, USA
      sug:
      ab: Purpose: To describe the technique and evaluate the performance of MRI-guided transgluteal in-bore-targeted biopsy of the prostate gland under local anesthesia in patients without rectal access. Methods: Ten men (mean age, 69 (range 57–86) years) without rectal access underwent 13 MRI-guided transgluteal in-bore-targeted biopsy of the prostate gland under local anesthesia. All patients underwent mp-MRI at our institute prior to biopsy. Three patients had prior US-guided transperineal biopsy which was unsuccessful in one, negative in one, and yielded GG1 (GS6) PCa in one. Procedure time, complications, histopathology result, and subsequent management were recorded. Results: Median interval between rectal surgery and presentation with elevated PSA was 12.5 years (interquartile range (IQR) 25–75, 8–36.5 years). Mean PSA was 11.9 (range, 4.8 -59.0) ng/ml and PSA density was 0.49 (0.05 -3.2) ng/ml/ml. Distribution of PI-RADS v2.0/2.1 scores of the targeted lesions were PI-RADS 5–3; PI-RADS 4–6; and PI-RADS 3–1. Mean lesion size was 1.5 cm (range, 1.0–3.6 cm). Median interval between MRI and biopsy was 5.5 months (IQR 25–75, 1.5–9 months). Mean procedure time was 47.4 min (range, 29–80 min) and the number of cores varied between 3 and 5. Of the 13 biopsies, 4 yielded clinically significant prostate cancer (csPca), with a Gleason score ≥ 7, 1 yielded insignificant prostate cancer (Gleason score = 6), 7 yielded benign prostatic tissue, and one was technically unsuccessful. 3/13 biopsies were repeat biopsies which detected csPCa in 2 out of the 3 patients. None of the patients had biopsy-related complication. Biopsy result changed management to radiation therapy with ADT in 2 patients with the rest on active surveillance. Conclusion: MRI-guided transgluteal in-bore-targeted biopsy of the prostate gland under local anesthesia is feasible in patients without rectal access.
      pubtype: Academic Journal
      doctype: Journal Article
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    language: English
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