Trying to avoid blind biopsy

PSA test leads to MRI

Latest PSA is 14.4, and my Free PSA is .007, biopsy seems necessary, the only option is in Toronto, Canada available from my urologist and my searches from the internet are trust. I have for now booked an MRI imaging ($1500), if it is positive, my urologist will perform a targeted biopsy with this MRI image, instead of blind-random trust, but I still prefer to have it done by perineal not transrectal, which is not offered by my urologist, any help?

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