ABSTRACT
Transrectal ultrasound (TRUS)-guided systematic biopsy, the current gold standard for the detection of prostate cancer, suffersfrom low sensitivity for clinically significant cancer. The use of diagnostic multiparametric MRI has increased the relevanceof targeted biopsy techniques such as MRI-TRUS fusion biopsy and direct (in-bore) MRI-guided biopsy, which have higherdetection rate for clinically significant cancer. Although primarily used in patients who remain at high clinical suspicion forprostate cancer despite a negative systematic biopsy, with the increasing use of upfront diagnostic MRI, these biopsies areexpected to replace routine systematic biopsies. This pictorial essay aims to enhance our understanding of the concepts ofthese biopsy techniques so that they can be performed safely and provide maximum diagnostic yield.