Omission of systematic transrectal ultrasound guided biopsy from the MRI targeted approach in men with previous negative prostate biopsy might still be premature

In the emerging field of MRI in prostate cancer (PCa) diagnosis, it has become clear that targeted biopsy with MRI guidance has additional value over systematic transrectal ultrasound-guided biopsies (TRUS-GB) alone. The MRI targeted biopsy approach increased the diagnostic yield of high-grade PCa, while concomitantly reducing the number of biopsy cores and the detection of low-grade PCa (1,2). Consequently, the question arises if in current clinical practice the TRUS-GB could be reduced or even omitted from the MRI targeted diagnostic process.