{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:26:43Z","timestamp":1790180803305,"version":"4.1.0"},"reference-count":93,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>The field of prostate cancer (PCa) diagnosis is undergoing a profound transformation from traditional invasive procedures toward precision, minimally invasive, and even non-invasive approaches. This article systematically outlines this evolutionary trajectory: first, starting with the selection of patients for biopsy, it emphasizes precision-based initial screening and risk-stratified biopsy strategies utilizing multiparametric magnetic resonance imaging (mpMRI) and prostate-specific antigen density; second, by comparing transrectal and transperineal biopsy, it elucidates the significant advantages of the transperineal approach in reducing the risk of infection and its status as the new standard pathway; further, it focuses on how biopsy strategies have evolved from systematic template biopsy to targeted, individualized fusion biopsyunder the guidance of precision imaging modalities such as mpMRI and prostate-specific membrane antigen positron emission tomography\/computed tomography; finally, we explore the application prospects, clinical validation pathways, and practical frameworks of the new \u201cbiopsy-free diagnosis\u201d paradigm\u2014based on advanced imaging and molecular biomarkers\u2014in radical surgery decision-making and active surveillance. The full text integrates the latest evidence-based data and proposes a structured clinical pathway, aiming to advance PCa diagnosis into a new era characterized by greater safety, precision, and individualization.<\/jats:p>","DOI":"10.3389\/fonc.2026.1835580","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:50:45Z","timestamp":1782276645000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Evolution of the prostate cancer diagnostic paradigm: integrated evidence and clinical pathways from targeted biopsy to biopsy-free strategy"],"prefix":"10.3389","volume":"16","author":[{"given":"Zhiyong","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Urology, Hunan Provincial People\u2019s Hospital, The First Affiliated Hospital of Hunan Normal University","place":["Changsha, Hunan, China"]},{"name":"Clinical Medical College, Hunan Normal 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