**5. Conclusions**

18F-PSMA and 68Ga-PSMA both show promising results in the detection of newly diagnosed PC with comparable correlation of PSMA-avid lesions with GS. Neither method showed an outstanding superior advantage. Studies reporting 18F-PSMA and 68Ga-PSMA are equally relevant for the staging of patients with PC. With regard to both methods, the importance of PSMA imaging for the detection of metastases is also clear in primary staging, especially in patients with high-risk and intermediate-unfavorable risk PC. Our calculated thresholds for the SUVmax value may represent valuable parameters in clinical use for the discrimination of csPC from non-csPC and may also serve to guide prostate biopsies and support the identification of aggressive PC foci.

**Author Contributions:** Conceptualization, M.A.H., J.M.-H., F.R., N.F. and M.S.; methodology, M.A.H., J.M.-H., F.R., N.F. and M.S.; software, M.A.H., J.M.-H., N.F. and H.-G.B.; validation, M.A.H., J.M.-H., F.R., N.F., H.-G.B., H.J.W. and M.S.; formal analysis, M.A.H., F.R., N.F., F.E.v.E., H.-G.B. and H.J.W.; investigation, M.A.H., J.M.-H., F.R. and H.J.W.; resources, M.A.H., J.M.-H., H.-G.B. and H.J.W.; data curation, J.M.-H., F.R., H.J.W. and M.S.; writing—original draft preparation, M.A.H., J.M.-H., F.R., N.F., H.-G.B. and M.S.; writing—review and editing, F.E.v.E., H.J.W. and M.S.; visualization, M.A.H., J.M.-H., H.-G.B. and M.S.; supervision, H.J.W. and M.S.; project administration, M.A.H., J.M.-H., F.R., N.F., H.J.W. and M.S. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding.

**Institutional Review Board Statement:** The study was conducted in accordance with the Declaration of Helsinki and the German Medicinal Products Act, § 13.2b. The Ethics Committee of the Medical Association North Rhine (Aekno) (protocol code 41/2019, approval date: 22 February 2019) approved the study.

**Informed Consent Statement:** Informed consent was obtained from all subjects involved in the study. All patients signed an informed consent (including evaluation and publication of their anonymized data).

**Data Availability Statement:** The datasets analyzed during the current study are available from the Practice of Radiology and Nuclear Medicine in Cologne/Germany, named "Praxis im KölnTriangle" upon reasonable request.

**Acknowledgments:** The authors wish to express their gratitude to Ed Michaelson, of Fort Lauderdale, Florida, USA, for language revision.

**Conflicts of Interest:** The authors declare no conflict of interest.

## **References**

