The purpose of this study is to examine current discoveries, assess the usefulness of MRI transrectal ultrasound fusion biopsy (FBx) methods, and explore future approaches. FBx identifies clinically significant prostate cancer (csPCa) at a much greater rate than an ultrasound-guided systematic prostate biopsy (SBx), especially in repeat biopsy situations. FBx has also been proven to identify clinically inconsequential prostate cancer at much lower rates. Furthermore, a specialized prostate MRI can help predict the Gleason score more precisely and offer additional information on the index cancer site, prostate volume, and clinical stage. The capacity to properly diagnose particular lesions is critical for both focused therapy and active surveillance, as it allows for treatment selection, planning, and sufficient follow-up.

Multiple high-quality studies have proven that FBx outperforms SBx in the diagnosis of csPCa. Combining FBx with emerging technologies such as radionics, prostate-specific membrane antigen positron emission tomography (PSMA PET), and high-resolution micro-ultrasound has the potential to improve performance even further.