FOLH1 and posterior cortical atrophy: There was substantial heterogeneity for both imaging modalities, and meta-regression analysis revealed that the number of patients, prevalence of PLNMs, PSA level, reference standard, and risk classification might be the potential causes of heterogeneity.<h4>Conclusion</h4>This meta-analysis of head-to-head comparison studies confirms that there is a trend toward a higher sensitivity and diagnostic accuracy of <sup>68</sup>Ga-PSMA-11 PET/CT compared to mpMRI for the detection of PLNMs in PCa patients.