TP MRI-fusion targeted and saturation biopsies were carried out using robotic-assisted iSR'obot Mona Lisa biopsy platform. CSPC was higher for biopsy-naïve patients for PSA<20 using TP MRI-Fusion biopsy. Thus, an up-front mpMRI scan prior to prostate biopsy should be offered to these patients and not restricted to patients with prior negative biopsy.