PRIMARY2 clinical trial results presented at EAU26 found that PSMA PET/CT imaging substantially reduced the need for invasive prostate biopsies in men with suspected cancer after equivocal or reassuring MRI. Investigators reported that PSMA‑based imaging improved lesion discrimination and negative predictive value, allowing clinicians to defer biopsy in a meaningful subset of patients without compromising detection of clinically significant disease. The trial’s findings could shift diagnostic algorithms for prostate cancer by integrating PSMA PET/CT earlier in the pathway, particularly for men with indeterminate MRI or those at higher procedural risk. Implementation will hinge on cost‑effectiveness analyses, access to PSMA scanning, and prospective validation of long‑term oncologic outcomes when biopsies are deferred based on PET findings.