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Prostate-specific membrane antigen (PSMA) is a type II transmembrane glycoprotein that is overexpressed by prostate cancer epithelial cells [1, 2]. Despite the specificity implied by its name, PSMA is also expressed by endothelial cells within the neovasculature of a number of solid malignancies including clear cell renal cell carcinoma (ccRCC)[3–5]. Utilizing PSMA-targeted 18F-DCFPyL positron emission tomography/computed tomography (PET/CT), we previously reported a sensitivity of 94.4% for detecting putative sites of disease in five patients with untreated metastatic ccRCC [6]. Notably, two (40%) of these patients had additional foci of radiotracer uptake (a total of 11 sites) that were suspicious for sites of metastases but lacked corresponding findings on conventional imaging. Similar results have since been reported using a gallium 68-labeled radiotracer targeting PSMA [7, 8]. Combined, these data support …