https://www.pcf.org/c/trexit-the-movement-to-leave-traditional-prostate-biopsy-behind/Good article on the advantages of Transperieal Biopsy vs traditional. disclosure: i read part not all of the article, skimmed the rest.
I spoke with a friend yesterday who is on AS and he told me (he heard this third party, not directly) that Johns Hopkins is now doing Transperineal only.