Arabi A, Deebajah M, Yaguchi G, et al. - Researchers examined the efficacy of the systematic 12-core prostate biopsy (SB) combined with MRI-targeted lesion biopsy (MRI-TB) vs MRI-TB alone in the diagnosis of high PI-RADS lesions. They analyzed 148 patients who were undergoing MRI-TB + SB for suspicious MRI lesions. These patients had undergone prostate biopsy previously and had undergone MRI to assess the need for a repeat biopsy. Upgrading from the previous biopsy was done in 141 lesions (55.3%) among the 255 total lesions (247 lesions with PI-RADS ≥ 3). Of these, the MRI-TB led to the upgrading of 104 lesion (40.8%), and the SB led to upgrading of 87 lesions (34.1%). Findings suggest that in a PIRADS-5 lesion, the MRI-TB had a meager no-upgrade (NU) rate. The MRI-TB alone without combining with SB may lead to the safe management of men with a PI-RADS 5 lesion. SB in addition to MRI-TB may benefit men with PI-RADS 3 and 4 lesions for precise management of their disease.