Figure 1.

A 68-year-old male was diagnosed, with a Gleason score of 3 + 4 = 7, with prostate adenocarcinoma in 2001, who then underwent external beam radiation therapy with medical castration therapy. He had biochemical recurrence starting in November 2014. He started medical castration therapy and finally his PSA (prostate specific antigen) level slowly progressed to 7.5 ng/mL in December 2018. ⁶⁸Ga-PSMA-617 PET/CT maximum intensity projection (MIP) image (A) demonstrates widespread abnormal activity in the supraclavicular (B) and mediastinal (C) lymph nodes, pelvic lymph nodes, prostate gland and bones (D). The patient was evaluated after two cycles of ¹⁷⁷Lu-PSMA-617 therapy for response to radioligand therapy. A significant response in skeletal and lymph node metastases was detected in ⁶⁸Ga PSMA-617 PET-CT MIP (E) and axial fused images (F–H) and serum PSA value decreased by approximately 80% (PSA value decreased from 7.5 to 1.53 ng/mL).