I insisted on a PET 5 yrs ago before surgery to see if there was any spread BEFORE going under the knife. Why bother if it had - just go right to radiation and hormones, right?
Ins co said ‘no way’ so I paid about $8K for Axumin - which was the only game in town. It was negative but meant nothing since I am now facing recurrence after the surgery.
IMO, get the transperineal biopsy (Only!!) and then take it from there. Even PSMA is not foolproof!