Progressing prostate cancer after docetaxel
History
71-year-old man with metastatic castration-resistant prostate cancer, progressing after enzalutamide and six cycles of docetaxel. PSA 86 ng/mL (doubling time 2 months), castrate testosterone, pelvic bone pain. Haemoglobin 118 g/L, platelets 210 ×10⁹/L, eGFR 68 mL/min/1.73 m², ECOG 1. Request: PSMA PET/CT to assess suitability for ¹⁷⁷Lu-PSMA-617.
Step 1 · Screening PSMA PET
All bone and nodal lesions show uptake well above liver. The largest node (para-aortic) is 18 mm in short axis and the liver is clear on CT. Does he meet the VISION imaging criteria?