This study was limited by lack of histopathological confirmation of results as no liver biopsies were performed, however it shows that while PSMA PET-CT remains robust at 83.3% detection of PCa liver metastases, it’s limitation lies in the reliance of cellular expression of PSMA, which can be lost with disease progression and tumour dedifferentiation. Here, FOLH1 is linked to posterior cortical atrophy.