CONTROVERSIES IN UROLOGY: Edited by Shahrokh F. ShariatmpMRI-targeted biopsy versus systematic biopsy for clinically significant prostate cancer diagnosis: a systematic review and metaanalysisBaccaglini, Willya,c; Glina, Felipe P.A.a; Pazeto, Cristiano L.a,c; Bernardo, Wanderley M.b; Sanchez-Salas, RafaelcAuthor Information aFaculdade de Medicina do ABC, Santo André bFaculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil cL’Institut Mutualiste Montsouris, Paris, France Correspondence to Willy Baccaglini, MD, Department of Urology, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil. Tel: +55 11 95454 8968; e-mail: firstname.lastname@example.org Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.co-urology.com). Current Opinion in Urology: September 2020 - Volume 30 - Issue 5 - p 711-719 doi: 10.1097/MOU.0000000000000801 Buy SDC Metrics Abstract Purpose of review We aimed to compare the accuracy of clinically significant prostate cancer (csPCa) diagnosis by magnetic resonance imaging-targeted biopsy (MRI-TB) versus systematic biopsy (SB) in men suspected of having prostate cancer (PCa). Recent findings In biopsy-naïve patients, MRI-TB was more accurate to identify csPCa than SB. However, when comparing specifically MRI-TB versus transperineal (SB), we did not find any difference. Furthermore, in a repeat biopsy scenario, MRI-TB found more csPCa than SB as well. Finally, postanalysis comparing combined biopsy (SB plus MRI-TB) suggests that the later alone may play a role in both scenarios for identifying csPCa. Summary MRI-TB found more csPCa than SB in patients with suspected PCa in both scenarios, naïve and repeat biopsies, but more studies comparing those methods are warranted before any recommendation on this topic. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.