Mona Lisa was used for performing both systematic and MRI-US fusion targeted biopsy in this retrospective study. The paper is addressing the need for systematic biopsy and the effect of the no of cores taken during systematic MRI-targeted biopsy. Reducing the number of systematic biopsies when performing an MRI-targeted biopsy leads to reduced detection of csPCa and alter the treatment plans for focal therapy, possibly limiting its oncological efficacy.