The PRIME clinical trial establishes that biparametric MRI (bpMRI) achieves equivalent diagnostic performance to multiparametric MRI (mpMRI) for identifying clinically significant prostate cancer, while eliminating the need for gadolinium contrast agents and reducing scan duration. This finding represents a significant advancement in prostate imaging efficiency without sacrificing accuracy. The contrast-free approach addresses multiple clinical barriers simultaneously: it reduces patient discomfort, eliminates risks associated with gadolinium exposure in patients with kidney dysfunction, and decreases imaging costs. More importantly, shorter scan times could dramatically expand access to prostate cancer screening, particularly in resource-limited settings where MRI availability remains constrained. However, the transition requires careful consideration of radiologist training and standardization across imaging centers. The equivalence demonstrated in PRIME validates what many urologists have suspected—that the additional sequences in mpMRI may not justify their complexity for routine screening. This could reshape prostate cancer detection protocols globally, potentially enabling earlier diagnosis in underserved populations while maintaining the diagnostic precision that has made MRI-guided biopsy the current gold standard.