In 1 high-risk patient with a PSA value of 30 ng/ml and Gleason score of 8 (4 + 4) with 4 regional lymph node metastases, [18F]FCH PET-CT was able to detect 1 additional lymph node (diameter 15 mm) in the internal iliac region, which was negative on [68Ga]Ga-RM2 PET-CT. This evidence concerns the gene KLK3 and metastatic malignant neoplasm in the lymph nodes.