前列腺癌(PCa)是男性最常见的恶性肿瘤，常规影像检查不能提供准确的原发期分期。前列腺特异性膜抗原（PSMA）正电子发射断层扫描（PET）表现出卓越的性能，并且强烈影响治疗选择。本研究的目的是评估PSMA PET与常规影像方法在PCa患者的原发期分期情况下对治疗方法的影响，这些患者在巴西国家公共卫生系统接受治疗。总体上，在使用多参数磁共振（MMR）和/或全腹部计算机断层扫描（CT）和骨扫描（BS）进行常规分期后，评估了35名被诊断为PCa的患者的PSMA。通过PET识别出的PCa扩展情况与常规影像进行比较；然后确定分期变化和管理影响。使用描述性统计分析PET与常规影像、分期和决策变化。 PET显示15名患者有局部病变（LD），5名患者有精囊侵犯（SVI），7名患者有骨盆淋巴结受损（PNI），3名患者有骨盆和远处淋巴结受损，4名患者有骨盆淋巴结和骨转移，1名患者有骨盆和远处淋巴结和骨转移。分期变化发生在60%的患者中，下分期优势（76.2%）。体积增加在11名患者中被发现（仅有4名与升分期相关，36.4%）。委员会改变了60%患者的管理决策。本研究的主要局限性是样本量和回顾性。 PSMA的发现改变了超过一半患者的管理决策，使大多数患者有资格接受局部治疗，并避免了系统性疾病情况下不必要的程序。©2023年。外科肿瘤学会。

Prostate cancer (PCa) is the most common malignant tumor in males and conventional imaging does not provide accurate primary staging. Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) presents superior performance and strongly affects therapeutic choice.The aim of this study was to evaluate the impact of PSMA PET, compared with conventional imaging methods, on the therapeutic approach in primary staging scenarios in patients with PCa treated at the Brazilian National Public Health System.Overall, 35 patients diagnosed with PCa were evaluated using PSMA after conventional staging imaging with multiparametric magnetic resonance (MMR) and/or total abdominal computed tomography (CT) scan and bone scintigraphy (BS). The PCa extension identified by PET was compared with conventional imaging; staging changes and the management impact were then determined. PET comparison with conventional imaging, staging, and decision-making changes was analyzed using descriptive statistics.PET revealed local disease (LD) in 15 (42.9%) patients, seminal vesicle invasion (SVI) in 5 (14.3%) patients, pelvic nodal impairment (PNI) in 7 (20%) patients, pelvic and distant nodes in 3 (8.6%) patients, pelvic nodes and bone metastasis in 4 (11.4%) patients, and pelvic and distant nodes and bone metastasis in 1 (2.8%) patient. Staging changes were observed in 60% of patients, with downstaging predominance (76.2%). Volume increase was identified in 11 (31.4%) patients (only 4 related to upstaging, 36.4%). The board changed management decisions for 60% of the patients. The main limitations of this study were the sample size and its retrospective nature.PSMA findings changed the management decisions in more than half of the patients, which made the majority eligible for locoregional treatment and avoided unnecessary procedures in the systemic disease scenario.© 2023. Society of Surgical Oncology.