Using [68Ga]-PSMA-HBED-CC PET imaging and magnetic resonance imaging before prostatectomy and quantitative immunofluorescence microscopy for PSMA and phosphorylated Akt, principal component analysis identified that PSMA expression and tracer uptake were more strongly correlated with Akt’s phosphorylation at S473 than other clinical indicators of prostate cancer, such as Gleason score and PSA, suggesting that PSMA-based PET imaging can serve as a predictor of the global activation status of the P1K-Akt pathway in prostatic lesions. This evidence concerns the gene KLK3 and Familial prostate cancer.