68Ga-PSMA PET/CT in Initial Diagnosis and Bone Metastasis Evaluation in Saudi Patients with High-Grade Prostate Cancer

We present the first study performed in Saudi Arabia to evaluate Ga-68-PSMA PET/CT in prostate cancer (PCa) initial diagnosis and its added value in bone metastases (BM) diagnosis in such patients. Twenty-six male patients underwent prostate histopathological examination and all imaging studies (Ga-68-PSMA PET/CT and CT); all of them were confirmed with highgrade PCa. Patients' mean PSA levels and Gleason score were 5.12 +/- 1.12 and 7.0 +/- 0.9, respectively. Ga-68-PSMA PET/CT (20/26; sensitivity of 76.9%) was superior to traditional CT (18/26; sensitivity of 69.2%) in PCa detection. There was a non-significant association (P=0.332) between patients' age and BM. Based on bone scintigraphy (BS), in patients without BM (n=16), (68)GaPSMA PET/CT detected metastasis-suspicious lesions in six patients (37.5%) and negative results in ten patients (62.5%). (68)GaPSMA PET/CT showed no false-negative cases among patients with confirmed BM using BS. In conclusion, Ga-68-PSMA PET/CT performed well in PCa initial diagnosis in Saudi male patients with high-grade tumors. Ga-68-PSMA PET/CT also accurately detected BM in all PCa patients with confirmed BM by BS. Larger prospective studies are urgently required to compare Ga-68-PSMA PET/CT diagnostic performance with other standard modalities in PCa and BM diagnosis.