We describe our initial experience using ProstaScint® scanning in addition to conventional imaging modalities for staging of high risk prostate cancer. Using our protocol, ProstaScint® images detected abnormalities in pelvic lymph nodes not seen on CT scan or magnetic resonance imaging (MRI) in two patients. Subsequent surgical pelvic lymphadenectomy confirmed these abnormalities. Further patients will be accrued on this study to estimate the sensitivity and specificity of ProstaScint® scanning.