<sup>68</sup>Ga-PSMA-11 PET/CT resulted in a change of target volume delineation for radiation therapy planning in 29 patients (20.9%).<h4>Conclusion</h4>In high-risk primary PCa, <sup>68</sup>Ga-PSMA-11 is safe and effective in local staging, resulting in changes in both surgical and radiation management. The gene discussed is FOLH1; the disease is posterior cortical atrophy.