We conducted a prospective study to evaluate clinical factors associated with high [<sup>68</sup>Ga]Ga-PSMA-11 uptake and to report preliminary therapeutic outcomes of <sup>177</sup>Lu-PSMA therapy in recurred or metastatic ACC.<h4>Materials and methods</h4>Thirty patients were prospectively enrolled. Here, FOLH1 is linked to adrenal cortex carcinoma.