Inclusion Criteria:

• Histologically confirmed carcinoma of the prostate (biopsy results with 12 months of enrollment)
• Intermediate risk as defined by NCCN criteria
• Conventional imaging (bone scan and abdominal pelvic computed tomography) is mandatory for NCCN unfavourable intermediate risk prostate cancer patients with PSA > 10. Negative nodal, skeletal or visceral metastases within 16 weeks of enrollment (for patients requiring staging). Alternatively, patients with no signs of extra-prostatic disease on PSMA-PET scans are also candidates for this trial
• ECOG performance status 0-1
• Willing to give informed consent to participate in this clinical trial
• Able and willing to complete QOL questionnaires Most responsive physician definition if androgen deprivation therapy will be used (only allowed for NCCN unfavourable intermediate risk prostate cancer)

Exclusion Criteria:

• Estimated prostate volume > 60cc (volume based on transrectal ultrasound)
• Prior TURP
• Prior prostate cancer treatment, including 5-alpha reductase inhibitor treatment
• Low, high or very high-risk disease as per NCCN guidelines
• Connective tissue disease or inflammatory bowel disease
• Contraindication to prostate microUS
• Men with double hip prostheses
• Contraindication for MRI (i.e. non-compatible stent, pacemaker, prosthesis etc.)
• Anticoagulation medication (if unsafe to discontinue for fiducial marker insertion)
• Diagnosis of bleeding diathesis