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Background Abdominal aortic aneurysm (AAA) is a focal aortic dilatation progressing towards rupture. Non-invasive AAA-associated cell proliferation biomarkers are not yet established. We investigated the feasibility of the cell proliferation radiotracer, fluorine-18-fluorothymidine ([ 18 F]FLT) with positron emission tomography/computed tomography (PET/CT) in a progressive pre-clinical AAA model (angiotensin II, AngII infusion). Methods and Results Fourteen-week-old apolipoprotein E-knockout (ApoE −/− ) mice received saline or AngII via osmotic mini-pumps for 14 ( n  = 7 and 5, respectively) or 28 ( n  = 3 and 4, respectively) days and underwent 90-minute dynamic [ 18 F]FLT PET/CT. Organs were harvested from independent cohorts for gamma counting, ultrasound scanning, and western blotting. [ 18 F]FLT uptake was significantly greater in 14- ( n  = 5) and 28-day ( n  = 3) AAA than in saline control aortae ( n  = 5) ( P  &lt; 0.001), which reduced between days 14 and 28. Whole-organ gamma counting confirmed greater [ 18 F]FLT uptake in 14-day AAA ( n  = 9) compared to saline-infused aortae ( n  = 4) ( P  &lt; 0.05), correlating positively with aortic volume ( r  = 0.71,  P  &lt; 0.01). Fourteen-day AAA tissue showed increased expression of thymidine kinase-1, equilibrative nucleoside transporter (ENT)-1, ENT-2, concentrative nucleoside transporter (CNT)-1, and CNT-3 than 28-day AAA and saline control tissues ( n  = 3 each) (all  P  &lt; 0.001). Conclusions [ 18 F]FLT uptake is increased during the active growth phase of the AAA model compared to saline control mice and late-stage AAA.

Cell proliferation detected using [18F]FLT PET/CT as an early marker of abdominal aortic aneurysm