68Ga-PSMA-11 PET/CT for Detecting Biochemical Recurrence after Radical Prostatectomy in a Racially Diverse Population with Low PSA Levels

INTRODUCTION: Ga-PSMA-11 PET/CT to explore BCR patterns between racial groups at low prostate-specific antigen (PSA) levels (≤ 2.0 ng/mL) post-RP. METHODS: Ga-PSMA-11 PET/CT-derived parameters (detection rate, standardized uptake values [SUVmax and SUVmean], PSMA tumor volume [PSMA-TV], and total lesion PSMA [TL-PSMA]), were collected and compared between groups. RESULTS: The overall detection rate was 57% (28/49), with 47% (8/17) in BAAM and 63% (20/32) in WAM (p = 0.39). BAAM had significantly higher baseline PSA levels (median: 13.80 versus 7.22 ng/mL; p < 0.001) and PSA density (0.59 versus 0.16 ng/mL²;p < 0.001). At recurrence, PSA levels and lesion distribution were statistically similar. While WAM exhibited slightly higher SUVmax and SUVmean, BAAM demonstrated higher PSMA-TV, TL-PSMA, and whole-body volumetrics (wbPSMA-TV and wbTL-PSMA); although the differences were not statistically significant, they highlight areas for future exploration. CONCLUSION: Despite BAAM presenting with more aggressive features at primary diagnosis, BAAM and WAM exhibited comparable PSMA-PET-derived tumor burden at recurrence. These findings will inform future studies with large, racially diverse populations.