A PI-RADS 4 lesion is usually recommended for a biopsy. That was my experience with two different MRIs and lesions. Make sure it's a MRI fusion guided biopsy that targets the lesion. And most combine targeted cores with random cores to sample all over the prostate. I've had both trans rectal and trans perineal biopsies and recommended the later as they say it provides better access to the entire prostate.