对于中/高风险前列腺癌，术前分期检查是强制性的。这些影像学研究的目的是评估最终的淋巴结受累和/或肿瘤的转移扩散。然而，计算机断层扫描（CT）、磁共振成像（MRI）、骨扫描方式的敏感性存在争议。 PET-PSMA 的引入及其也用作术前检查，由于有利的阴性预测值，似乎可以提高诊断准确性。本研究的目的是评估 PET-PSMA 作为术前分期检查的准确性及其预测中/高危前列腺癌 (PCa) 患者淋巴结受累的准确性。对 50 例诊断为中/高危前列腺癌 (PCa) 患者进行回顾性分析已进行 2018 年至 2022 年间的风险 PCa。所有患者在机器人辅助根治性前列腺切除术 (RARP) 扩大盆腔淋巴结清扫术 (ePLND) 之前均接受术前 68Ga-PSMA PET/CT。该队列被分为两组：病理阴性淋巴结（pN0）与阳性淋巴结（pN1）。进行了描述性和比较分析。使用斯皮尔曼等级检验进行连续变量之间的相关分析。以淋巴结组织病理学结果为参考标准，计算68Ga-PSMA PET/CT的诊断性能。总共纳入50例患者。平均年龄为 63.3 岁，中位前列腺特异性抗原 (PSA) 为 7.7 ng/dL。 44% 的患者的国际泌尿病理学会 (ISUP) 评分为 4 或更高，28% 的患者处于 pT3 阶段。总体而言，接受 ePLND 的 43 名患者（86%）没有出现淋巴结转移（pN0），而 8 名患者（14%）为 pN1。 PET-PSMA 在检测淋巴结转移方面表现出较低的敏感性 (25%)，而在排除淋巴结疾病方面表现出较高的特异性 (88.1%)。最后，我们注意到前列腺的总 SUVmax 与初始总 PSA 之间存在显着的正相关性（r=0.38；P=0.019），以及肿瘤受累百分比（r=0.383） ；P=0.022）。关于 PET-PSMA 在 PCa 初级分期中的作用的证据正在稳步积累。 SUV 与前列腺受累之间的正相关表明 PET-PSMA 可以很好地近似反映前列腺的病理特征。然而，所描述的低灵敏度仍然是主要限制。需要未来的前瞻性研究来确定对患者结果的影响。

In intermediate/high risk prostate cancer, preoperative staging exams are mandatory. The aim of these imaging studies is to evaluate eventual lymph nodes involvement and/or metastatic spread of the tumor. Nevertheless, computed tomography (CT), magnetic resonance imaging (MRI), bone scan modalities have controversial sensitivity. Introduction of PET-PSMA and its use also as preoperative exam, seems to improve diagnostic accuracy due to favorable negative predictive value. The aim of this study was to evaluate the accuracy of PET-PSMA as a preoperative staging exam and its accuracy in predicting lymph nodes involvement in intermediate/high risk prostate cancer (PCa) patients.A retrospective analysis of 50 patients diagnosed with intermediate/high risk PCa between 2018 and 2022 has been performed. All patients underwent preoperative 68Ga-PSMA PET/CT prior to robot-assisted radical prostatectomy (RARP) + extended pelvic lymph node dissection (ePLND). The cohort was categorized into two groups: pathologically negative lymph nodes (pN0) vs. positive nodes (pN1). A descriptive and comparative analysis was conducted. Correlation analysis between continuous variables was performed using the Spearman's Rank Test. Using lymph nodes histopathological results as reference standard, the diagnostic performance of 68Ga-PSMA PET/CT was calculated.Overall, 50 patients were included. The mean age was 63.3 years with a median prostatic specific antigen (PSA) of 7.7 ng/dL. Forty-four percent of the patients exhibited an International Society of Urological Pathology (ISUP) score of 4 or higher, and 28% had a pT3 stage. Overall, 43 (86%) patients submitted to ePLND did not present lymph node metastases (pN0), while 8 (14%) patients were pN1. PET-PSMA showed low sensitivity in detecting lymph node metastases (25%) while a high specificity in excluding lymph-node disease (88.1%) has been observed. Finally, we noted a significant positive correlation between the total SUVmax of the prostate and the initial total PSA (r=0.38; P=0.019), as well as the percentage of tumor involvement (r=0.383; P=0.022).Evidence on the role of PET-PSMA in the primary staging of PCa is steadily building up. A positive correlation between SUV and prostate involvement indicates that PET-PSMA could reflect, with a good approximation, the pathological features of the prostate. However, the low sensitivity depicted remains the main limitation. Future prospective studies are needed to determine the impact on patient outcome.