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. 2018 May 23;13:98. doi: 10.1186/s13014-018-1037-7

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© The Author(s). 2018

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Fig. 1 — A 83-year-old patient with castration-resistant prostate cancer (Gleason-Score:9) and an increasing prostate-specific antigen (PSA) level. He had a history of prostatectomy and radiation therapy of prostate bed. The 68 Ga-PSMA PET scan showed a diffuse bone and bone marrow involvement (a). The PSA and ALP levels prior to the first cycle of Lu-PSMA therapy were 261 ng/ml and 659 U/l, respectively. The patient received 2 cycles of Lu-PSMA and the PSA level decreased continuously during cycles from 261 to 9.0 ng/ml (8 weeks after the second cycle). The ALP showed also a decreasing value from 659 to 81 U/l (8 weeks after the second cycle). The PSMA-PET (b) 8 weeks after the second cycle showed a significant response with significant regression of PSMA