Magnetic resonance imaging starting to gain traction and the diagnosis of prostate cancer. Traditional approach is used transrectal ultrasound. There is very little evidence comparing the 2 approaches. In this multicenter randomized non-inferiority trial, men with high suspicion for prostate cancer, who had not undergone biopsy, were randomized to MRI with or without a biopsy or transrectal ultrasound with biopsy. The total 500 men were recorded. 20% of men of the MRI arm did not have any suspicious lesions suggestive of prostate cancer. 38% of the men who underwent a biopsy were found to have evidence of cancer. This is in comparison to 26% in the standard biopsy. Fewer men in the MRI biopsy group were diagnosed with cancer versus the standard ultrasound guided biopsy group. The authors concluded that a risk stratification so magnetic resonance imaging is superior to standard transrectal ultrasound-guided biopsy and then left clinical risk prostate cancer. While magnetic resonance imaging is more expensive approach, it can help avoid unnecessary biopsies.