MR guided Prostate Biopsy (MRgBx) yielded a Gleason upgrading in 37.5% of the patients with prior GS6 biopsy tumors. Overall diagnostic yield of MRI guided prostate biopsy was 58.3%. Men with positive MRgBx had tumors which were larger in size, lower ADC value, and higher T2, DWI and overall score compared to men with negative MRgBx. PiRADS reporting is an accurate measure to predict positive MR guided biopsy targets.