Consistent results throughout repeated biopsy sessions is an essential requirement for any tool used for active surveillance. TRUS biopsy showed inconsistent results in repeated biopsy sessions. Regarding MRI guided biopsy, the reliability of repeated biopsies needs to be established. 5 patients with 17 lesions which were repeatedly biopsied under direct MRI guidance were included. Kappa statistics showed moderate agreement. Negative predictive value for 2nd biopsy was 93% and for 3rd biopsy was 90%. Consistent biopsy results may obviate the need for the current paradigm of obtaining annual prostate biopsies in patients undergoing active surveillance
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