Prostate cancer is the most common malignancy in Western men, with a 15-year survival rate of 94% for patients diagnosed early, but overtreatment is a current problem. Because of this, the most pressing issue in current treatment should be the assessment of tumor risk. According to a recent study published in JAMA, multiparametric MR targeted biopsy combined with rectal ultrasound imaging, as a functional and molecular imaging, is superior to conventional 12-point systematic puncture biopsy for the detection and assessment of high-risk prostate cancer. However, there are no clinical data to prove this. This new technique uses MRI imaging combined with transrectal ultrasound imaging for real-time monitoring, resulting in a three-dimensional image of the prostate for examination. In contrast, the traditional 12-point puncture biopsy method relies more on luck, and one can only pray that one of the 12 points will capture the lesion, otherwise the tumor will not be monitored, leaving one in a dilemma. In addition, the traditional puncture biopsy is performed from the back and tumors in the front are easily missed, and it cannot distinguish all cancers well, but it can tell the malignancy of the cancer according to the Gleason classification. The NIH study, which began in 2007, included 1003 patients with elevated prostate cancer-specific antibodies (PSA) or abnormal rectal examinations (DRE); some patients had negative biopsies but continued to be monitored for high PSA and abnormal DRE. Patients agreed to undergo both standard and targeted biopsies. The results of the study showed that 461 patients with prostate cancer were detected by targeted biopsy and 469 patients with prostate cancer by standard biopsy. 690 of 1003 patients (69%) had a risk classification consistent with the two biopsy methods. Although the number of patients detected by both biopsy methods was approximately the same, the targeted biopsy method detected 30% more patients with high-risk cancers and 17% fewer patients with low-risk cancers. The standard puncture biopsy method combined with targeted biopsy detected an additional 103 (22%) cancer patients, 83% of whom were at low risk, 12% at intermediate risk and 5% at high risk. The researchers estimate that every 200 standard biopsies combined with targeted biopsies will result in the diagnosis of one additional high-risk cancer patient. In turn, for every high-risk cancer patient identified, the standard biopsy method identified 17 additional low-risk cancer patients. The combination of the two biopsy methods did not change the Gleason score in the 857 patients. In terms of sensitivity and specificity, a comparison of biopsy samples and resected prostate tissue showed that the ratio of sensitivity of targeted biopsy to standard biopsy was 77% : 53%, and the specificity was similar (68% : 66%). In addition, the combined biopsy method can somewhat calm patients with low-risk, very small lesions that do not show up on MRI and cannot be captured by targeted biopsy, who may live a normal life and eventually die of other causes without the mental shock of learning of their condition, which can be detrimental to their health. The discovery of this new technology can influence active monitoring of the condition to some extent, and doctors will be able to tell some patients with confidence that their condition is not serious through targeted biopsies, rather than relying on random 12-point biopsies. Physicians were also able to choose more appropriate treatment options in the treatment. The study also had some limitations, such as not assessing recurrence and mortality rates in clinical cases; patients with no lesions on the images were excluded, which may have contributed to the low detection rate of low-risk cancers shown in the study. Other experts agree that the study is exciting and that any test that can reduce patient harm is very appealing, even if the clinical data are unknown, but caution that further investigation is needed before the technology can be widely used.