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Article History

Received: 18 August 2025

Accepted: 31 December 2025

First Online: 28 January 2026

Compliance with ethical standards

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: The scientific guarantor of this publication is Ivo Schoots.

: R.G.H.B.T. is a member of the scientific editorial board of European Radiology (section: Oncology) and, as such, did not participate in the selection or review processes for this article. The remaining authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

: Not applicable.

: Written informed consent was not required for this study because we used publicly available datasets.

: Institutional Review Board approval was not required because we use publicly available datasets.

: This study utilizes publicly available datasets (PI-CAI, PROMIS, Prostate158) and newly generated annotations on subsets of these data. To the best of our knowledge, there is no subject overlap with prior publications or work currently under review from our group using these specific patient cohorts for different analyses. The novelty of this work lies in the systematic comparison of supervised, semi-supervised (including our proposed mtU-Net), and fully supervised DL strategies for aggressive prostate cancer segmentation using these datasets, particularly focusing on performance generalizability via external validation.

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