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Our study found that transperineal MRI/US biopsy, using TBx with ipsilateral SBx around the multiparametric MRI-suspected prostate lesion, yielded a very high detection rate for clinically significant prostate cancer (ISUP2), without hindering the detection of increased-risk prostate cancer (ISUP3). Furthermore, this strategy diminishes the number of biopsy cores per patient by 8-10, concurrently lessening procedure time, pathology processing costs, and the detection rate of ci