Context

Systematic transrectal ultrasound-guided prostate biopsy has been the recommended approach in primary prostate cancer (PCa) diagnosis for decades. An alternative diagnostic approach involves multiparametric MRI (mpMRI) that is highly sensitive in identifying clinically significant PCa (csPCa).1 Biopsy cores, targeting suspicious lesions identified on mpMRI, have shown to detect similar or higher rates of csPCa and lower rates of clinically insignificant PCa than systematic biopsy (SBx).2 Although the difference is clear in men with a history of negative biopsy, conflicting results have been published in biopsy-naïve men. The PRECISION trial3 is the first multicentre randomised controlled trial investigating non-inferiority of MRI-targeted biopsies (TBx) in biopsy-naïve men.