Sequential Imaging of Suspicion of Prostate Cancer Reducing Overdiagnosis and Unnecessary Biopsy With Timely Diagnosis of Significant Cancer

Inclusion Criteria: * Life expectancy \> 10 years * initial PSA \< 20 ng/ml * No signs of extracapsular disease on digital rectal examination * Intermediate-risk category for suspicion of prostate cancer determined by MRI results and PSA density (PSAD): PI-RADS 3 or PI-RADS 4 with PSAD =\< 0.15 * Mentally competent and able to comprehend the potential benefits and burdens of the study * Willing to undergo the follow-up protocol for a maximum of four years * written and signed informed consent Exclusion Criteria: * Men who have previously undergone a prostate biopsy * Men who have a prior PCa diagnosis * using any (anti-)hormonal therapy, including 5-alpha-reductase inhibitors * Proven germline mutation for PCa (for example: BRCA1; BRCA2) * Secondary malignancy, besides basal cell carcinoma of the skin, for which the potential participant is receiving active treatment at the time of inclusion. * severe claustrofobia or other conditions that make (repeat) MRI unsuitable (e.g., metal implants, pacemakers)