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[18F]4F-MHPG is a radiopharmaceutical used as a positron emission tomography (PET) imaging agent for quantifying regional cardiac sympathetic nerve density. It is a fluorine-18 labeled analog of meta-hydroxyphenethylguanidine, designed to selectively target and accumulate in sympathetic nerve terminals via the norepinephrine transporter. The compound demonstrates favorable imaging properties, including rapid liver clearance and consistent plasma metabolism, which improve heart-to-liver contrast and reduce background signal compared to other tracers. Initial human studies have shown that [18F]4F-MHPG provides high-quality cardiac PET images with robust quantification of sympathetic innervation, making it particularly useful for assessing denervation in conditions such as cardiomyopathy and heart failure[3][5][8].
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