The INNOVATE trial (ClinicalTrials.gov: NCT02689271; combIning advaNces in imagiNg with biOmarkers for improVed diagnosis of Aggressive prosTate cancer) is a prospective cohort study evaluating the value of additional fluidic biomarkers and a novel diffusion-weighted MRI technique to the mpMRI-directed diagnostic pathway for suspected prostate cancer [16] Here we present the clinical diagnostic outcomes of the mpMRI-directed pathway of the INNOVATE study and examine the distribution of mpMRI scores and PSA density (PSAD) in this cohort in relation to clinically significant cancer on biopsy. Here, KLK3 is linked to Familial prostate cancer.