Follow Jeff’s advice. I cannot imagine the urologist rushing straight into a biopsy after the PSA dropped from 6 to 4. At the minimum waiting 4 months for another PSA. Do you have a history of his PSA levels. Even if the PSA becomes a concern, The MpMRI of the prostate is standard of care before a biopsy today to see if any lesions can be identified for a MRI guided fusion biopsy of the lesions. A template guided random biopsy is old school before the advent of the MpMRI. His urologist may just not be up to date to where most urologist are. Now the MRI can help avoid a unnecessary biopsy at the time if nothing is seen with then continued monitoring of the PSA. One can as part of the decision if still in question about doing a biopsy after the MRI, one can take a non invasive urine marker test called ExoDx prostate test. This test analyzes for three RNA biomarkers to assess a person’s risk of having clinically significant prostate cancer. If the number came back low it would validate that the MRI did not see anything, while a higher number would push for more surveillance or a biopsy.