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To develop and validate a prostate cancer (PCa) risk calculator (RC) incorporating multiparametric magnetic resonance imaging (mpMRI) and to compare its performance with that of the Prostate Biopsy Collaborative Group (PBCG) RC. A total of 1010 patients were included for development and 371 for external validation. The mpMRI‐based PLUM RC significantly outperformed the PBCG RC and was compared favourably with other mpMRI‐based RCs. As a result, a large proportion of biopsies could be avoided using the PLUM RC in shared decision-making while maintaining optimal detection of csPCa.
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