Computed Tomography–Guided Prostate Sampling and Fiducial Marker Insertion in Patients With Absent Rectums

Objectives We aimed to present our experience and the outcomes of a novel technique, computed tomography (CT)–guided prostate biopsy and fiducial marker insertion in patients with absent rectums. Methods Patients who underwent CT-guided prostate biopsy at a single institution from November 2010 to November 2022 were retrospectively reviewed. Patients were included if they had a clinical suspicion of prostate cancer and had absent rectums from previous surgical resection. Contrast-enhanced CT scan was used to perform transgluteal prostate biopsy. Patient demographics, multiparametric magnetic resonance imaging, and biopsy details were recorded. Results Thirteen biopsy procedures and 1 CT-guided fiducial marker insertion were performed on 12 unique patients. The reasons for the absence of rectums included surgical resection for rectal cancer (n = 10) and surgical resection for inflammatory bowel disease (n = 2). Clinically significant cancer was found in 7 of 13 biopsy results (52.8%), clinically insignificant cancer in 3 of 13 (23.1%), and benign cancer in 3 of 13 (23.1%). No complications were recorded. Conclusions Our data support CT-guided prostate biopsy as an accurate and effective technique for investigating prostate cancer that requires tissue sampling in patients with absent rectums.