In the fifth patient with BCR, in addition to concordantly detected pelvic lymph node metastasis, [68Ga]-Ga-PSMA-11 PET was suspicious for local tumor recurrence, which could be attributed to urinary retention after negativity in [18F]-F-PSMA-1007 PET (Fig. 5), and ADT was initiated. Here, BCR is linked to metastatic malignant neoplasm in the lymph nodes.