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A retrospective single-center cohort of 3379 consecutive patients biopsied 2012–2023 underwent DRE and mpMRI before biopsy. DRE showed low sensitivity (0.17) and limited incremental utility versus PSA and PSA density. Results indicate minimal to no added diagnostic value when PSA and mpMRI are initial screening tools.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/digital-rectal-exam-vs-electronic-digitized-prostate-exam/446408/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/digital-rectal-exam-vs-electronic-digitized-prostate-exam/446408.png","ImageObject",300,407,{"name":92,"@type":93},"Cipher","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What was the purpose of comparing DRE with an electronic digitized prostate exam approach?","Question",{"text":113,"@type":114},"The study aimed to define the diagnostic value of pre-biopsy DRE for screening and detecting clinically significant prostate cancer when mpMRI and PSA are available as initial tools.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was the study conducted and who were the participants?",{"text":118,"@type":114},"It was a retrospective single-center study of 3379 consecutive patients who underwent biopsy from 2012 to 2023 using MRI/US-targeted fusion and systematic approaches, with DRE and mpMRI performed before biopsy.",{"name":120,"@type":111,"acceptedAnswer":121},"What diagnostic performance did DRE show for csPCa detection?",{"text":122,"@type":114},"For csPCa detection, DRE had sensitivity of 0.17 and specificity of 0.92, with a positive predictive value of 0.63 and a negative predictive value of 0.59, which was worse than PSA and PSA density.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},446408,1790742077,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},687208528416,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Borde etal. BMC Urology (2026) 26:2 [https://doi.org/10.1186/s12894-025-01936-y](https://doi.org/10.1186/s12894-025-01936-y)  \nBMC Urology  \nRESEARCH Open Access  \nDigital rectal exam vs. electronic “digitized”  \nprostate exam  \nTabea Borde 1, Nicole A. Varble 1,2*, Alexander Kenigsberg3, Lindsey A. Hazen 1, Laetitia Saccenti 1,4, Peter A. Pinto3, Baris Turkbey5 and Bradford J. Wood 1,3,6  \nAbstract  \nBackground The current era of multiparametric prostate MRI (mpMRI) and ultrasound (US)/ MRI fusion has improved early detection of clinically significant prostate cancer (csPCa) while decreasing the number of unnecessary biopsies. Hence, this study aims to define the diagnostic value of pre-biopsy digital rectal examination (DRE) for screening and detection of csPCa, when there is access to mpMRI and prostate-specific antigen (PSA) .  \nMethods This retrospective, single-center study involved 3379 consecutive patients biopsied between 2012 and 2023 using both MRI/US-targeted fusion and systematic approaches. Biopsies were indicated because of elevated PSA levels and/or presence of cancer suspicious lesions on MRI. All patients underwent DRE and mpMRI prior to biopsy. csPCa was defined as Gleason grade group ≥2 . Diagnostic performance of DRE for csPCa was compared to PSA and PSA density (PSAD) using receiver operating characteristic curves.  \nResults Two thousand one hundred eighty-eight (65%) patients were diagnosed with PCa and 1498 (44%) patients with csPCa. DRE was positive in 410/3379 (12%) patients. 261/410 (64%) DRE positive patients had confirmed csPCa, of which 160/261 (61%) were located in immediate proximity to the rectum. mpMRI was positive for focal lesion(s) in 1494/1498 (100%) csPCa patients. For csPCa detection, DRE had a sensitivity of 0 . 17, specificity of 0 . 92, a positive predictive value of 0.63 and a negative predictive value of 0.59. Compared to DRE (AUC 0.55 [CI95% 0 . 54, 0 . 56]), PSA (AUC 0.63 [CI95% 0 . 61, 0 . 64]) and PSAD (AUC 0.73 [CI95% 0 . 71, 0 . 74]) showed better csPCa prediction performance (both p \u003C 0. 001) .  \nConclusions Pre-biopsy DRE was found to add little to no diagnostic value for the routine diagnostic workflow in a constrained setting when PSA and mpMRI are initial screening tools for patients with suspected csPCa.  \nKeywords Prostate, Prostatic cancer, Image-Guided biopsy, Magnetic resonance imaging, Digital rectal examination, Prostate-Specific antigen  \n*Correspondence:  \nNicole A. Varble  \n[nicole.varble@nih.gov](nicole.varble@nih.gov)  \n1Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA  \n2Philips Healthcare, Cambridge, MA 02141, USA  \n3Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA  \n4Henri Mondor Biomedical Research Institute, Inserm U955, Team N°18, Créteil, France  \n5Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA  \n6Center for Interventional Oncology, Radiology and Imaging  \nSciences, Clinical Center, National Institute of Biomedical Imaging and Bioengineering and National Cancer Institute Center for Cancer Research, National Institutes of Health, Bethesda, MD 20892, USA  \nThis is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in t","cbCais9zbzoR0ENf","https://ap.wps.com/l/cbCais9zbzoR0ENf","pdf",1298686,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusions\n# Background\n## Prostate cancer screening context\n## Limitations and evolving role of DRE","[{\"question\":\"What was the purpose of comparing DRE with an electronic digitized prostate exam approach?\",\"answer\":\"The study aimed to define the diagnostic value of pre-biopsy DRE for screening and detecting clinically significant prostate cancer when mpMRI and PSA are available as initial tools.\"},{\"question\":\"How was the study conducted and who were the participants?\",\"answer\":\"It was a retrospective single-center study of 3379 consecutive patients who underwent biopsy from 2012 to 2023 using MRI/US-targeted fusion and systematic approaches, with DRE and mpMRI performed before biopsy.\"},{\"question\":\"What diagnostic performance did DRE show for csPCa detection?\",\"answer\":\"For csPCa detection, DRE had sensitivity of 0.17 and specificity of 0.92, with a positive predictive value of 0.63 and a negative predictive value of 0.59, which was worse than PSA and PSA density.\"}]","Digital rectal exam vs. electronic digitized prostate exam | PDF",1790715311,23]