Anterior and apical samplings during transperineal image-guided prostate biopsy

•Cancer detection rate from anterior and apical prostate biopsies is almost 20%.•The added value as part of a combined targeted and systematic scheme is limited.•Detection of insignificant cancer and postoperative complications are not increased.•Patients with PI-RADS 5 lesions may benefit from anterior and apical samplings.•Candidates for focal therapy may benefit from anterior and apical samplings.•Patients with PI-RADS 5 lesions and candidates for focal therapy may benefit from anterior and apical samplings.