Klotz L, Pond G, Loblaw A, et al. - In this 2-yr postconfirmatory biopsy (CBx) follow-up for the ASIST trial, which is a prospective, randomized, multicenter, open-label study for men with Gleason grade group 1 cancer eligible for active surveillance (AS), experts ascertained whether there was a variation in the AS failure rate in a 2-yr follow-up period among men who underwent MRI prior to primary CBx in comparison with those who did not. A total of 259 men underwent CBx, in the non-MRI (n = 132) and in the MRI arm (n = 127). Over 2 yr, baseline MRI prior to CBx during AS led to 50% lesser AS failures and fewer grade progression. Thus, AS failure rates may be impacted by the center, where MRI and targeted biopsy is done.