Predictive value of the 68Ga-PSMA-11 PET/CT PRIMARY score for pathological upgrading in patients with ISUP Grade 1 prostate cancer and PSA < 20 ng/mL undergoing radical prostatectomy

"The ⁶⁸Ga-PSMA-11 PET/CT PRIMARY score was strongly associated with pathological upgrading in this surgically treated cohort of biopsy-confirmed ISUP GG1 patients with PSA < 20 ng/mL undergoing radical prostatectomy. Incorporating PSMA-based intraprostatic pattern analysis could improve the accuracy of preoperative grading, potentially supporting consideration of surgical management rather than definitive radiotherapy when determining the optimal treatment strategy. Prospective multicenter validation is warranted before broader clinical implementation.