Therapeutic Consequences of 68Ga-PSMA-11-PET/CT in Prostate Cancer in Correlation to the Gleason Score, PSA Value, and D’Amico-Defined Risk Groups

<b>Background/Objectives</b>: The aim of this study was to demonstrate the importance of ⁶⁸Gallium (⁶⁸Ga)-prostate specific membrane antigen (PSMA)-positron emissions tomography (PET)/computed tomography (CT)(PET/CT) in prostate cancer patients for therapy management with individual analyses regarding the Gleason score, prostate specific antigen (PSA) value, and the risk groups defined by D'Amico. <b>Methods</b>: We retrospectively analyzed 562 ⁶⁸Ga-PSMA-11-PET/CT examinations performed from January 2015 to March 2023 at University Hospital Marburg. We assessed treatment changes post ⁶⁸Ga-PSMA-11-PET/CT and categorized the cases based on PSA values, Gleason scores, and D'Amico risk groups. <b>Results</b>: In 415/562 (73.8%) of ⁶⁸Ga-PSMA-11-PET/CT examinations, a modification in the therapy concept was recorded. Patients categorized as high risk or patients with Gleason scores of 7 through 10 or with PSA levels above 0.5 ng/mL (particularly within the ranges of 1.01-2 ng/mL, 3.01-5 ng/mL, and values exceeding 10 ng/mL) demonstrated a statistically significant association with treatment change. While no evidence of the disease was found most frequently in 38% of cases in the "Therapy continued without explicit reference" group, in the group with the adapted therapy, there was a considerable higher proportion of local tumors (19.2%) compared to the other groups (4.4% and 1.4%). <b>Conclusions</b>: Our results show the high impact of ⁶⁸Ga-PSMA-PET/CT for patients with prostate cancer regarding therapy management planning, which is even more important for some patient groups.