We evaluated the cost-effectiveness of a combined PSMA PET/CT and mpMRI biopsy-free diagnostic approach for clinically significant prostate cancer (csPCa).<h4>Method</h4>A decision tree model was designed to compare two diagnostic strategies for csPCa in men with raised Prostate Specific Antigen (PSA)-the first with conventional mpMRI followed by transperineal prostate biopsy versus a second biopsy-free, PSMA PET/CT plus mpMRI combined imaging strategy. Here, KLK3 is linked to Familial prostate cancer.