68Ga-PSMA-11 PET/CT Initial Staging in Black and White South African Males with ISUP Grade Group 1 and 2 Prostate Adenocarcinoma

Letjie C Maserumule; Kgomotso M G Mokoala; Christophe van de Wiele; Gbenga Popoola; Khanyisile N Hlongwa; Honest Ndlovu; Alex Maes; Mariza Vorster; Mike M Sathekge

doi:10.3390/biomedicines10040882

⁶⁸Ga-PSMA-11 PET/CT Initial Staging in Black and White South African Males with ISUP Grade Group 1 and 2 Prostate Adenocarcinoma

Biomedicines. 2022 Apr 12;10(4):882. doi: 10.3390/biomedicines10040882.

Authors

Letjie C Maserumule¹, Kgomotso M G Mokoala¹, Christophe van de Wiele^{1

2}, Gbenga Popoola³, Khanyisile N Hlongwa¹, Honest Ndlovu¹, Alex Maes^{1

4}, Mariza Vorster^{1

5}, Mike M Sathekge^{1

5}

Affiliations

¹ Department of Nuclear Medicine, Steve Biko Academic Hospital, University of Pretoria, Pretoria 0001, South Africa.
² Department of Diagnostic Sciences, University Ghent, 9000 Ghent, Belgium.
³ The Wolds, Discovery House, Lincolnshire NHS Partnership Foundation Trust, Lincoln LN1 1FS, UK.
⁴ Department of Morphology and Medical Imaging, Katholieke Universiteit Leuven, 8500 Leuven, Belgium.
⁵ Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria 0001, South Africa.

Abstract

Prostate adenocarcinoma (PCa) is a leading cause of mortality. Black males with high-risk PCa have a poorer prognosis compared to white males. Patients with International Society of Urological Pathology (ISUP) Grade Group (GG) 1 and 2 PCa have little potential for metastases post radical prostatectomy. ⁶⁸Gallium prostate specific membrane antigen (⁶⁸Ga-PSMA) PET/CT imaging for metastatic PCa is superior to conventional imaging in staging high-risk PCa. No strong evidence is available to support imaging low-risk patients. We aimed to evaluate the value of ⁶⁸Ga-PSMA PET/CT in black and white South African (BSA and WSA) males with GG1 and 2 PCa at initial staging. We evaluated 25 WSA and 123 BSA males. The image findings were correlated with prostate specific antigen (PSA). PSA levels significantly correlated with both primary tumor and whole-body PSMA-tumor volume (PSMA-TV) and were higher in BSA males. No differences were noted in the occurrence of metastases; however, PSA, seminal vesicle invasion and black race predicted metastases. Our findings suggest higher PSMA expression and tumor burden in BSA with histologically low-risk PCa, and future research with immunohistochemistry evaluation will be essential to confirm these findings.

Keywords: 68Ga-PSMA PET/CT; PSMA; prostate cancer; racial differences.