Comparison of Diagnostic Yield of Digital Rectal Examination, Serum Prostate Specific Antigens, Transrectal Ultrasound with Histopathology of Prostate

Introduction: We aimed to compare systematic biopsies (SBs) of in-bore magnetic resonance-guided prostate biopsy (MRGpB) with those performed under transrectal ultrasound (TRUS) guidance in the clinical setting. Methods: Data on all 161 consecutive patients undergoing prostate biopsy in our institution between November 2017 and July 2019 were retrospectively collected. The patients were referred to biopsy due to elevated prostate-specific antigen (PSA) and/or abnormal digital rectal examination and/or at least one Prostate Imaging Reporting and Data System (PI-RADS) lesion score of ≥3 on multiparametric magnetic resonance imaging (mpMRI). We included patients with PSA levels ≤20 ng/ml and those with 8–12 core biopsies. Histology results of SBs performed by in-bore MRGpB were compared to TRUS SBs. Chi-squared, Fischer’s exact, and multivariate Pearson regression tests were used for statistical analysis (SPSS, IBM Corporation). Results: In total, 128 patients were eligible for analysis. Their median age was 68 years (interquartile range [IQR] 61.5–72), mean prostate size 55±29 cc, and mean PSA and PSA density levels 7.6±3.5 ng/ml and 0.18±0.13 ng/ml/cc, respectively. Thirty-five patients (27.3%) had suspicious digital rectal examination findings. Both biopsy groups were similar for these parameters. Thirty-eight (62.3%) MRGpB patients had a previous biopsy vs. 5 (7.1%) TRUS-SB patients (p<0.0001). The number of patients diagnosed with clinically significant and non-significant disease was similar for both groups. High-risk disease was more prevalent in the TRUS-SB group (22.4% vs. 4.9%, p<0.01). Conclusions: Our data suggest that in-bore MRGpB is no better than TRUS for guiding SBs for the detection of clinically significant prostate cancer.

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The clinical utility of transrectal ultrasound and digital rectal examination in the diagnosis of prostate cancer

British Journal of Radiology ◽

10.1259/0007-1285-67-799-668 ◽

1994 ◽

Vol 67 (799) ◽

pp. 668-671 ◽

Cited By ~ 14

Author(s):

A Shapiro ◽

P D Lebensart ◽

D Pode ◽

R A Bloom

Keyword(s):

Prostate Cancer ◽

Clinical Utility ◽

Transrectal Ultrasound ◽

Digital Rectal Examination ◽

Rectal Examination

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No Increased Prostate Cancer Incidence After Negative Transrectal Ultrasound Guided Multiple Biopsies in Men with Increased Prostate Specific Antigen and/or Abnormal Digital Rectal Examination

The Journal of Urology ◽

10.1097/01.ju.0000087325.57314.5c ◽

2003 ◽

Vol 170 (4 Part 1) ◽

pp. 1180-1183 ◽

Cited By ~ 7

Author(s):

ANNA BILL-AXELSON ◽

LARS HOLMBERG ◽

BOJOHAN NORLÉN ◽

CHRISTER BUSCH ◽

MONA NORBERG

Keyword(s):

Prostate Cancer ◽

Prostate Specific Antigen ◽

Cancer Incidence ◽

Specific Antigen ◽

Transrectal Ultrasound ◽

Digital Rectal Examination ◽

Ultrasound Guided ◽

Prostate Cancer Incidence ◽

Rectal Examination ◽

Multiple Biopsies

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Digital Rectal Examination Is a Valuable Bedside Tool for Detecting Dyssynergic Defecation: A Diagnostic Study and a Meta-Analysis

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2021/5685610 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Jie Liu ◽

Chaolan Lv ◽

Yizhou Huang ◽

Ying Wang ◽

Dandan Wu ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Diagnostic Yield ◽

Meta Analysis ◽

Digital Rectal Examination ◽

Functional Constipation ◽

Cochrane Library ◽

Diagnostic Study ◽

Dyssynergic Defecation ◽

Rectal Examination ◽

Physiological Tests

Background. Accurate dyssynergic defecation (DD) diagnosis depends on anorectal physiological tests that are not widely available. Aim. The purpose of this study is to evaluate the diagnostic yield of digital rectal examination (DRE) compared with anorectal physiological tests in diagnosing DD in patients with constipation. Methods. A total of 218 chronic constipation patients who fulfilled the Rome IV diagnostic criteria for functional constipation (FC) and underwent a standardized DRE and high-resolution anorectal manometry (HRAM) test were enrolled in this study. The diagnostic accuracy of DRE compared with HRAM was evaluated, and the agreement between DRE and HRAM was calculated. Furthermore, a comprehensive literature search on PubMed, Web of Science, Cochrane Library, and Embase database was conducted to further elucidate the pooled diagnostic accuracy of DRE in DD patients. Results. A total of 101 patients (46.33%) had a DD pattern using HRAM, while 117 patients (53.67%) were diagnosed without DD. The sensitivity of DRE in diagnosing dyssynergia was 71.3%, and the specificity was 76.1%. There was a moderate agreement between DRE and HRAM for diagnosing DD (κ-coefficient = 0.474, P < 0.001 ). Meanwhile, six studies (including our study) comprising 964 constipated patients were included in our meta-analysis. The outcomes demonstrated that the AUC was 0.85 (95% CI 0.82–0.88) with 77% summary sensitivity (95% CI 65–86) and 80% summary specificity (95% CI 71–86) to diagnose DD. Conclusions. DRE could be a valuable tool for screening DD. Our study revealed acceptable sensitivity and specificity of DRE in detecting dyssynergia compared with the physiological tests. Meanwhile, our study highlights that DRE remains an important tool in clinical practice.

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