MAGNETIC resonance imaging (MRI) T staging demonstrated comparable prognostic performance to digital rectal examination for patients with localised prostate cancer undergoing radical prostatectomy, suggesting that MRI based staging could be incorporated into contemporary risk classification systems without compromising predictive accuracy. Magnetic resonance imaging is increasingly used for local staging in prostate cancer, although its value compared with traditional digital rectal examination has remained uncertain. The primary outcome was distant metastasis free survival, while biochemical recurrence free survival and overall survival were evaluated as secondary outcomes. Researchers also assessed whether magnetic resonance imaging derived T staging could replace digital rectal examination staging within four established prognostic classification systems. Findings Supported MRI T Staging IntegrationThe findings suggested that magnetic resonance imaging based T staging could replace digital rectal examination based staging within established prostate cancer risk models without reducing prognostic performance.