FLT = [F-18] Fluorothymidine
FLT is a unique PET tracer in which it targets cellular proliferation, the rate of DNA synthesis, in patients to evaluate the effectiveness of anti-neoplastic drugs affecting DNA replication. The thymidine component of the FLT does not actually get incorporated into the DNA replication process because of a phosphorylation event creating an ionic FLT-MP (monophosphate). It is FLT-MP that gets trapped within the proliferating cells.
Majority of the patients that we see are already on their cycles of
anti-neoplastic treatment when imaging with F18-FLT. Normal
bio-distribution of FLT includes the bone marrow, lymphoid tissue, kidneys and bladder.
Imaging with FLT is no different than FDG, except for the fact that the injected dose is based on 3MBq/kg rather than 5MB/kg with respect to FDG. At least at our institution. The post injection imaging time is still relatively the same, approximately 60 minutes +/- 10 minutes however it is not necessary to obtain blood glucose measurements since the mechanism of action is different than that of FDG.
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