A PI-RADS 3 score means an intermediate risk for prostate cancer, also called a "gray zone," where the result is equivocal. It indicates that a radiologist is unsure if cancer or inflammation is present, and it is often managed with further investigation like a biopsy to get a definitive result.

What is your PSA Density, PSA Doubling Time, and % Free PSA? Those will help you determine which way to go.

If still unsure, I would get the MRI-guided biopsy. That’s the only way to know for sure,