FOLH1 and metastatic neoplasm: These findings highlight that patients with localized PCa on conventional imaging may harbor occult (oligo-)metastatic disease that can be uncovered using PSMA-PET.17, 18, 19 The European Association of Urology (EAU) guidelines still do not recommend PSMA-PET as first-line imaging modality, as little is known if the PSMA-PET-based change in therapy leads to better survival outcomes or health-related quality of life (QOL).15