OBJECTIVE: This study aimed to compare the upgrade rate and cancer detection rate between the METHODS: Eighty-seven selected biopsy-naive patients were randomized into two groups: TB ( RESULTS: In the study, prostate cancer was ultimately detected in all patients. The TB group successfully identified all tumors, whereas five patients in the control group initially missed diagnosis. The pathological upgrade rates for the TB and control groups were 31.7 % and 56.5%, respectively. Overall, the detection rate for clinically significant prostate cancer (the International Society of Urological Pathology grade of ≥2) was significantly higher in the TB group (92.7%) compared with the control group (76.1%, CONCLUSION: The