Jeffrey Karnes, MD, and Geoffrey Johnson, MD, both of Mayo Clinic, introduce the phase 3 CLARIFY trial, which used advanced PSMA PET imaging to improve surgical outcomes for high-risk prostate cancer patients. They discuss how PSMA PET imaging can better identify lymph node involvement before surgery and how it may change the course of treatment, potentially reducing the need for extensive lymph node dissections. With data from the COBRA and PROPELLER trials showing that longer imaging times improve lesion detection, the CLARIFY trial could lead to more precise surgical planning and better patient outcomes.