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Purpose: To report a planned analysis of the efficacy and toxicity of dose escalation to the intraprostatic dominant nodule identified on multiparametric magnetic resonance imaging using standard and hypofractionated external beam radiation therapy. Methods and Materials: DELINEATE is a single centre prospective phase 2 multicohort study including standard (cohort A: 74 Gy in 37 fractions) and moderately hypofractionated (cohort B: 60 Gy in 20 fractions) prostate image guided intensity modulated radiation therapy in patients with National Comprehensive Cancer Network intermediate-and high-risk disease. Patients received an integrated boost of 82 Gy (cohort A) and 67 Gy (cohort B) to lesions visible on multiparametric magnetic

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Highlights5 mm mapping prostate biopsies correlated with imaged intra-prostatic tumour.Diffusion-restricted tumour of ≥0.5 cm3 can be dose-escalated with confidence.Tumours of <0.5 cm3 should not be dose-escalated.Diffusion-weighted MR has good diagnostic accuracy for dominant tumour lesions.