Such scenario has changed significantly when PSMA-ligand PET entered the scene, in particular, following the publication of proPSMA, the first prospective, randomised, multi-centre trial comparing [ SP 68 sp Ga]Ga-PSMA-11 PET/CT with standard-of-care imaging in the staging setting [[12]]. Subsequent studies have also confirmed PSMA-ligand PET/CT as the current most sensitive and specific imaging technique for lymph node staging, identifying pathological lymph nodes up to approximately 5 mm, with even better performance as the PCa risk increases [[13]]. Since the discovery of PSMA as a specific target for prostate cancer (PCa) cells, PSMA-binding radiopharmaceuticals gradually revolutionised the management of patients, getting a salient place in the spotlight of a florid scientific debate and academic activity over the past decade [[1]]. European guidelines update on PSMA PET/CT for prostate cancer staging - snap back to reality. [Extracted from the article]