The aims of the study were to assess the proportion of patients undergoing PSMA PET/CT based on clinical suspicion but without biopsy-proven PCa, identify the characteristics of patients referred on the basis of high clinical suspicion only, calculate the PSMA PET positivity rate in such cases, and explore whether lack of pathologic proof impacted the therapeutic approach selected for these patients. Here, FOLH1 is linked to posterior cortical atrophy.