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The clinical characteristics of patients with primary non-prostate-specific membrane antigen-expressing prostate cancer on preoperative positron emission tomography/computed tomography Prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/CT is a modern imaging tool used in the diagnosis of prostate cancer (PCa). About 10% of patients who undergo PSMA PET/CT have a biopsy confirmed, primary PCa without PSMA expression on PET/ CT (non-PSMA PET -expressing PCa) according to a recent systematic review [1]. However, the definition of non-PSMA PET -expression in these studies was poorly defined and no immunohistochemical studies for confirmation of PSMA protein expression were performed. The aim of this retrospective study was to report the prevalence, characteristics, and immunohistochemical assessment of non-PSMA PET -expressing hormone-sensitive PCa in a cohort of 362 patients who underwent PSMA PET/CT and robotassisted radical prostatectomy (RARP).This study was approved by the local Institutional Review Board (IRBdm19-348). All patients had biopsy confirmed, hormone-sensitive, D'Amico intermediate-to high-risk PCa and were surgically treated in a high-volume RARP centre between 2016 and 2020. The patients underwent PSMA PET/

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