Klin Onkol 2026; 39(5): 320-324. DOI: 10.48095/ccko2026320.
The aim is to summarize recent findings on the diagnostic value of Ga-68 PSMA PET/CT imaging in patients with intermediate- and high-risk prostate cancer scheduled for radical prostatectomy and its impact on decision-making regarding simultaneous performance of pelvic lymphadenectomy. The focus is on sensitivity, specificity, and negative predictive value of this imaging modality in detecting lymph node metastases; the limitations of the examination are discussed, and situations in which the results may influence therapeutic management are outlined. Based on currently available data, a negative PSMA PET/CT result significantly reduces the probability of lymph node involvement. However, despite a negative PSMA PET/CT scan, risk of lymph node involvement remains approximately 10% in intermediate-risk tumors and 20–40% in high-risk tumors. Nomograms for estimating the risk of lymph node involvement are already available and incorporate PSMA PET/CT findings into their calculations. Therefore, the decision to perform lymphadenectomy should be individualized according to the patient’s risk profile.