MRI with targeted biopsy is as effective for prostate cancer investigation as transrectal ultrasound-guided (TRUS) biopsy and has the benefit of avoiding biopsy in about one third of men, researchers say.

However, the results of the PRECISE randomised controlled trial at five Canadian sites are not as strong as those from the earlier, influential PRECISION trial and are more in keeping with observational studies and the literature, according to an accompanying editorial.

In PRECISE, 453 men recommended for prostate biopsy, and considered to be at 5% or higher risk of having prostate cancer of International Society of Urological Pathology (ISUP) grade 2 or more, were randomised to an MRI-targeted biopsy or a conventional TRUS biopsy.

Those assigned to the MRI group only had a biopsy if their scan showed a lesion scoring 3 or higher according to the Prostate Imaging Reporting and Data System (PI-RADS 2.0), the authors wrote in JAMA Oncology.