Conversely, in patients with high GS, integrating [18F]FDG PET/CT increased the detection rates of local recurrence, lymph node metastases, and distant metastases from 0 to 7.7%, 30.8 to 61.5%, and 53.8 to 61.5%, respectively, compared to PSMA-ligand PET/CT alone (21). This evidence concerns the gene FOLH1 and metastatic malignant neoplasm in the lymph nodes.