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Fluorothymidine F 18 (FLT) is a radiolabeled thymidine analogue used as a PET imaging radiopharmaceutical to visualize and quantify cellular proliferation. As a small molecule tracer, it is taken up by cells and phosphorylated by the enzyme thymidine kinase 1 (TK1), an enzyme that is significantly upregulated during the S-phase of the cell cycle. Unlike thymidine, phosphorylated FLT is not incorporated into DNA but is trapped within the cell, allowing for the PET-based assessment of proliferative activity in tumors and normal tissues. In clinical research led by Dr. John M. Buatti at the University of Iowa, FLT PET is specifically utilized to map active bone marrow in patients with pelvic cancer. This functional mapping enables radiation oncologists to design intensity-modulated radiation therapy (IMRT) plans that spare active bone marrow regions, thereby potentially reducing hematologic toxicity and improving the delivery of concurrent chemoradiotherapy.
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