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  2-[18F]Fluoro-L-thymidine (FLT)
  The level of proliferation is a key parameter for characterisation of neoplastic lesions. DNA synthesis is the process that is most reliably associated with proliferation. Thymidine has also been successfully labelled with 11C, and the tracer uptake is directly related to cell proliferation. However, use of 11C-thymidine is hampered by the short isotope half-life, the difficult radiosynthesis and the presence of circulating radiolabelled metabolites. Several alternative compounds, labelled with 18F, have thus been proposed, including 3’-deoxy-3’-[18F]-fluorothymidine (FLT). Nucleosides, including FLT, enter the cells by facilitated diffusion and by a carrier-mediated mechanism. Once inside the cell, nucleosides are phosphorylated. Although four kinases are involved in the nucleoside metabolism, FLT is only handled by thymidine kinase TK1. TK1 expression is strictly controlled in normal cells and is only enhanced in the late G1 phase and the S phase. It is much higher, by up to 15-fold, in tumour cells.  
   
  Some Applications of [18F]-3’-Fluoro-3’-Deoxy-L-Thymidine [FLT]
 
S.No Applications Resource
1 Detection and Grading of Soft Tissue Sarcomas of the Extremities with 18F-3’-Fluoro-3’-Deoxy-L-Thymidine David C. P. Cobben, et al. Clin Cancer Res., 2004, 10, 1685.
2 18F-FLT PET in Hematologic Disorders: A Novel Technique to Analyze the Bone Marrow Compartment Ali Agool, et al. J Nucl Med., 2006, 47, 1592.
3 3’-18F-Fluoro-3’-Deoxy-L-Thymidine: A New Tracer for Staging Metastatic Melanoma? David C.P. Cobben. J Nucl Med., 2003, 44, 1297.
4 Early Response Assessment Using 3’-Deoxy-3’-[18F]Fluorothymidine Positron Emission Tomography in High-Grade Non-Hodgkin’s Lymphoma Ken Herrmann, et al. Clin Cancer Res., 2007, 13, 3552.
5 Imaging gastric cancer with PET and the radiotracers 18F-FLT and 18F-FDG: a comparative analysis Ken Herrmann, et al. J Nucl Med., 2007, 48, 1945.
6 Imaging Proliferation in Lung Tumors with PET: 18F-FLT Versus 18F-FDG Andreas K. Buck, et al. J Nucl Med., 2003, 44, 1426.
 
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