[en] ["6"8Ga]PSMA-HBED-CC ("6"8Ga-PSMA) is a novel and promising tracer for highly sensitive combined integrated positron emission tomography and X-ray computed tomography (PET/CT) diagnosis of recurrent prostate cancer (PCA). Our aim was to assess the sensitivity, specificity, positive and negative predictive value (PPV/NPV), and accuracy per lesion, as well as the positive predictive value per patient of "6"8Ga-PSMA PET/CT using post-lymphadenectomy histology as a standard, and to compare these values to those obtained in a patient collective scanned using "1"8F-Fluoroethylcholine ("1"8FEC) PET/CT. Thirty eight patients had "1"8FEC and 28 patients had "6"8Ga-PSMA. We performed a pelvic and/or retroperitoneal lymphadenectomy, if necessary supplemented by resection of locally recurrent lesions in accordance with imaging results. In 30/38 "1"8FEC and 23/28 "6"8Ga-PSMA patients ≥1 focus of PCA was identified in postsurgical histology, leading to a per-patient PPV of 78.9 % for "1"8FEC and 82.1 % for "6"8Ga-PSMA. In "1"8FEC and "6"8Ga-PSMA patients, a total of 378 and 308 lymph nodes and local lesions were removed, respectively. For "1"8FEC and "6"8for Ga-PSMA, the respective sensitivity (95 % confidence interval) was 71.2 % (64.5-79.6 %) and 86.9 % (75.8-94.2 %), specificity was 86.9 % (82.3-90.6 %) and 93.1 % (89.2-95.9 %), PPV was 67.3 % (57.7-75.9 %) and 75.7 % (64.0-98.5 %), NPV was 88.8 % (84.4-92.3 %) and 96.6 % (93.5-98.5 %), and accuracy was 82.5 % (78.3-86.8 %) and 91.9 % (88.7 %-95.1 %). In the present series Ga-PSMA PET/CT shows a better performance than FEC PET/CT with a significantly higher NPV and accuracy for the detection of locoregional recurrent and/or metastatic lesions prior to salvage lymphadenectomy. (orig.)