Inclusion Criteria:

• Histologically confirmed diagnosis of adenocarcinoma of the prostate

• Favorable risk disease defined as either:

  • Low risk disease: T1-T2c, grade group 1, PSA < 10 ng/ml or
  • Favorable intermediate risk disease: One of T2c, grade group 2, or PSA 10-20 ng/ml. Patients cannot have percent core positivity > 50%

• Prostate volume < 60 cc as determined by US, CT or MRI

• Ability to undergo MR imaging

• Provide written informed consent

Exclusion Criteria:

• Documented nodal or distant metastases
• Previous pelvic radiotherapy
• Previous transurethral resection of prostate, previous prostatectomy or HIFU
• Use of androgen deprivation therapy. Use of 5-alpha-reductase inhibitors permitted
• Poor baseline urinary function defined as International Prostate Symptom Score (IPSS) >15
• Contra-indication to radical prostate radiotherapy e.g. connective tissue disease or inflammatory bowel disease
• Significant medical co-morbidity rendering patient unsuitable for general anaesthesia