Objective: This study aimed to evaluate the correlation between 68Ga-PSMA uptake in PSMA PET/CT in primary prostate cancer (PC) and its histopathological grading (Gleason score and ISUP grade). Additionally, we compared preoperative biopsy histopathological findings with definitive pathology results in radical prostatectomy (RP) specimens. Methods: We retrospectively analyzed 86 patients who underwent 68Ga-PSMA PET/CT for primary PC staging, of which 40 patients later underwent radical prostatectomy. PET/CT results, including SUVmax values, were correlated with GS and PSA concentrations. Histopathology reports were analyzed and compared between biopsy and final pathology results following RP. Results: A significant positive correlation was observed between SUVmax and ISUP grades (Pearson’s ρ = 0.34, p < 0.001), with higher SUVmax values associated with more advanced grades. A cut-off SUVmax value of 5.64 was determined to predict upstaging in patients, yielding a sensitivity of 76% and a specificity of 60% (AUC = 0.82, 95% CI: 0.70–0.94). Additionally, 57.5% of patients experienced a grade shift following RP, with a 35% upgrade and 22.5% downgrade in ISUP grades. Conclusion: 68Ga-PSMA PET/CT demonstrated high sensitivity in detecting high-risk prostate cancer, particularly in patients with GS > 7 or PSA levels ≥ 10 ng/mL. The findings suggest that this imaging modality may be less effective for the staging of patients with lower GS or PSA values, that is, low-risk PCa. Further prospective studies are necessary to validate these results.

Objective: The study aims to evaluate the correlation between 68Ga-PSMA uptake in PSMA PET/CT in primary prostate cancer (PC) and its histopathological grading (Gleason Score and ISUP grade). Additionally, we compared preoperative biopsy histopathological findings with definitive pathology results in radical prostatectomy (RP) specimens. Methods: We retrospectively analyzed 86 patients who underwent 68Ga-PSMA PET/CT for primary PC staging, of which 40 patients later underwent radical prostatectomy. PET/CT results, including SUVmax values, were correlated with GS and PSA concentrations. Histopathology reports were analyzed and compared between biopsy and final pathology results following RP. Results: A significant positive correlation was observed between SUVmax and ISUP grades (Pearson's ρ = 0.34, p < 0.001), with higher SUVmax values associated with more advanced grades. A cut-off SUVmax value of 5.64 was determined to predict upstaging in patients, yielding a sensitivity of 76% and a specificity of 60% (AUC = 0.82, 95% CI: 0.70–0.94). Additionally, 57.5% of patients experienced a grade shift following RP, with a 35% upgrade and 22.5% downgrade in ISUP grades. Conclusion: 68Ga-PSMA PET/CT demonstrated high sensitivity in detecting high-risk prostate cancer, particularly in patients with GS > 7 or PSA levels ≥ 10 ng/ml. The findings suggest that this imaging modality may be less effective for staging of patients with lower GS or PSA values, that is low-risk PCa. Further prospective studies are necessary to validate these results.

Gallium-68 prostate-specific membrane antigen positron emission tomography/computed tomography (Ga-68 PSMA-PET/CT) is a diagnostic tool used in urology to detect oligometastatic disease in patients with prostate cancer (PC). Although increasingly popular and extensively studied, it is not considered a standard diagnostic tool for primary PC staging, because it lacks validation when compared to mpMRI.Numerous studies have suggested its promising role in PC diagnostics. Our objective was to comprehensively review and summarize the existing literature on the potential and feasibility of utilizing Ga-68 PSMA-PET/CT as the sole method for primary PC staging and to compare it with currently employed diagnostic tools (mainly mpMRI). The main goal of the study was to consolidate the data on the sensitivity and specificity of PSMA-PET for PCa staging when compared with other diagnostic tools. The use of PSMA-PET/CT as the only diagnostic tool of primary PC in the future might potentially reduce diagnostic time and costs. In addition, we examined the limitations of its use. Ga-68 PSMA-PET/CT demonstrates encouraging outcomes during the initial assessment of PC, potentially leading to a transformative leap in PC diagnosis and treatment, due to the utilization of Ga-68 PSMA, with high affinity to prostate cells.

This study explores potential for the utilization of the Da Vinci sin-gle-port (SP) system in robotic-assisted radical prostatectomy (RARP) for prostate cancer. The SP system offers significant advancements in minimally invasive surgery, with benefits such as 360° operative field visualization, poten-tial for reduced blood loss, faster recovery, improved cosmetics, integrated op-tics and instruments, and enhanced depth perception. While comparable onco-logical and functional outcomes are achieved between SP and multi-port (MP) systems, the SP system presents a unique advantage in reducing surgical trauma. This study emphasizes the SP system’s potential to enhance patient care while acknowledging the steeper learning curve for surgeons.