Positron Emission Tomography/Computed Tomography is a valuable tool to detect lymph node (LN) metastases in patients with biochemical failure after primary treatment for prostate cancer (PCa). The aim was to assess the predictive role of imaging parameters derived by (11)C-choline PET/CT (choline-PET/CT) on survival outcomes: overall survival (OS), loco regional- (lRFS), clinical- (cRFS) and biochemical relapse free survival (bRFS) in patients treated with helical tomotherapy (HTT) for LN recurrence.