The diagnosis of prostate cancer often relies on puncture biopsy, the standard biopsy being a 6 o’clock position puncture biopsy under ultrasound guidance. Recently, with the introduction of multiparametric magnetic resonance (MP-MRI), targeted MRI/ultrasound fusion-guided biopsy (i.e., targeted biopsy) electronically overlays MR images in real time on top of transrectal ultrasound images to biopsy suspicious lesions, allowing for a more targeted biopsy of the prostate. Siddiqui et al. of the National Cancer Institute conducted a prospective cohort study evaluating targeted biopsy, standard biopsy, and a combination of targeted and standard biopsy in the diagnosis of intermediate-risk and high-risk prostate cancer. The article was recently published in JAMA. The study included 1003 patients who underwent targeted biopsy or standard biopsy between 2007 and 2014 at the National Cancer Institute, based on criteria such as elevated PSA, abnormal rectal exam and at least one lesion in the prostate on MP-MRI, with exclusion criteria being patients with prior prostate cancer treatment and contraindications to MP-MRI. In the study, 461 patients with prostate cancer were diagnosed with targeted biopsy and 469 patients with standard biopsy. Targeted biopsy diagnosed 30% more high-risk prostate cancers than standard biopsy and 17% fewer low-risk prostate cancers than standard biopsy. When standard biopsies were combined with targeted biopsies, an additional 103 prostate cancers were diagnosed (83% low risk, 12% moderate risk, and 5% high risk). In 170 patients who underwent prostatectomy with whole gland pathology, targeted biopsy predicted a higher sensitivity (77% vs. 53%) and similar specificity (68% vs. 66%) than standard biopsy in agreement with whole gland pathology. These results show that targeted biopsy improves the diagnosis of high-risk prostate cancer compared to standard biopsy, but decreases the diagnosis of low-risk prostate cancer. Targeted biopsy is more accurate and sensitive than standard biopsy in predicting prostate cancer. Siddiqui et al. noted the clinical importance of targeted MRI/ultrasound fusion-guided biopsy in the diagnosis of prostate cancer and its recurrence and mortality, but the cost of targeted biopsy is much higher than that of standard biopsy, limiting the use of targeted biopsy.