Abstract: Objective To study the role of dual tracer of FLT-FDG PET/CT imaging in decision of treatment modalities for pulmonary nodules. Methods A prospective multi-center clinical trial was performed to investigate the changes in decision of diagnosis and treatment of pulmonary nodules using the SUV_max as a semi-qualitative index for metabolic level,6-17 month pathological and clinical follow-up data as the diagnostic criteria,and questionnaires. Results Malignant tumor,tuberculosis,and other benign lesions were detected in 16,16 and 23 of the 55 patients.The SUV_max value on ¹⁸F-FLT and ¹⁸F-FDG was significantly higher for malignant lesions than for benign lesions.The decision of treatment modalities for pulmonary nodules was changed in 26（47%）,significantly changed in 18（33%）,and partially changed in 8（14%） of the 55 patients,respectively,according to the FDGFLT images.Most of the changes in decision of treatment modalities for pulmonary nodules,such as drug treatment protocol,were correct as confirmed during the follow-up.However,the change in decision of treatment modalities for pulmonary nodules in 3 patients was incorrect. Conclusion Dual-tracer PET/CT imaging using ¹⁸F-FDG and ¹⁸F-FLT plays an important role in making decision of treatment modalities for pulmonary nodules.