Images show 2-(3-{1-carboxy-5-[(6-[18F]fluoro-pyridine 3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid (18F-DCFPyL) PET/CT–positive, multiparametric MRI–negative, and biopsy-positive lesion in a 65-year-old man (prostate-specific antigen level of 1.85 ng/mL) with history of prostate cancer and prior radical prostatectomy, now with biochemically recurrent prostate cancer. 18F-DCFPyL depicted pathologically proven metastatic lesion in right hemipelvis (arrow in [a] PET, [b] PET/CT, and [c] CT) that was missed at multiparametric MRI review due to obscuring susceptibility artifacts from surgical clips at (d) T2-weighted MRI, (e) b = 2000 sec/mm2 diffusion-weighted MRI, (f) apparent diffusion coefficient map, and (g) dynamic contrast material–enhanced MRI.