In this single-center retrospective series of 48 men undergoing prostatectomy after pre-op PSMA PET (± mpMRI), the pathologic DIL matched the hemigland of the largest PSMA and mpMRI lesion in 94% and 90% of cases, respectively. Median size discrepancy between imaging and pathology was modest—3.4 mm for PSMA and 4 mm for mpMRI—but imaging underestimated true lesion diameter in 59% (PSMA) and 64% (mpMRI), with >5 mm discordance in up to 26% and 42%, respectively. PSMA and mpMRI are usually right about where the DIL lives, but they often low-ball how big it is, particularly in higher PSA disease or lower grade disease. | Farmer, Adv Radiat Oncol 2026
