All patients were examined with PET/MRI (SIGNA PET/MR 3T, GE Healthcare, Milwaukee, WI USA) before radical prostatectomy. The mean number of days between imaging and surgery was 35 (range: 5–132 days). The MRI-protocol was a diagnostic multiparametric pelvic protocol, including morphological three-plane T2-weighted (T2W) sequences (transaxial, coronal, and sagittal). MRI-parameters are shown in Supplementary Table 1A.

Based on the three-plane T2W MRI, the prostatic volume was delineated in RayStation version 4.5 (RaySearch Laboratories AB, Stockholm, Sweden) by a medical physicist (either KS or JJ) and reviewed by a radiologist (SS). This delineation was used as input when finalizing the structure using the model-based segmentation tool in RayStation (Fig. 1A). From this, two structures were created by adding a margin of 1 and 2 mm, respectively, and exported as DICOM radiotherapy (RT)-structs.

Creation of prostate molds; Flowchart of how an individually designed prostate mold, used in this study, is created. A) A three-plane T2W MRI is used to delineate the volume of the prostate (white ROI). B) The delineated prostatic volume is subtracted from a pre-designed mold (C) that consists of two parts constructed with a locking mechanism holding the box together (D).

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