The definition of high-risk PCa is based on clinical T stage (cT3–4), blood prostate-specific antigen (PSA) level (>20 ng/mL), or Gleason score (≥7) (9), and these are the criteria that usually guide clinicians on whether to refer patients for PSMA PET/CT once PCa is histopathologically confirmed. Here, KLK3 is linked to posterior cortical atrophy.