This study investigated the biodistribution and myocardial homing of autologous bone marrow cells (BMCs) after intracoronary transfer in patients with acute myocardial infarction (AMI). BMCs were labeled with 18F-FDG and imaged using 3D PET to assess their distribution in the infarcted myocardium. The study included three groups: unselected BMCs infused intracoronarily, unselected BMCs injected intravenously, and CD34-enriched BMCs infused intracoronarily. After intracoronary transfer, 1.3% to 2.6% of 18F-FDG-labeled unselected BMCs were detected in the infarcted myocardium, with the majority of activity found in the liver and spleen. In contrast, intravenous transfer showed no activity in the infarcted myocardium. CD34-enriched BMCs showed higher retention in the infarcted myocardium, with 14% to 39% of total activity detected, indicating more pronounced homing in the border zone of the infarct. The study concluded that 18F-FDG labeling and 3D PET imaging can effectively monitor BMC homing and biodistribution after therapeutic application in patients with AMI. The findings suggest that intracoronary transfer is more effective than intravenous transfer for BMC delivery, as it allows for better homing to the infarcted myocardium. CD34-enriched BMCs showed higher retention in the myocardium compared to unselected BMCs, indicating their potential for more effective tissue repair. The study also highlights the importance of monitoring BMC biodistribution to optimize therapeutic outcomes and understand the mechanisms of BMC action in AMI.This study investigated the biodistribution and myocardial homing of autologous bone marrow cells (BMCs) after intracoronary transfer in patients with acute myocardial infarction (AMI). BMCs were labeled with 18F-FDG and imaged using 3D PET to assess their distribution in the infarcted myocardium. The study included three groups: unselected BMCs infused intracoronarily, unselected BMCs injected intravenously, and CD34-enriched BMCs infused intracoronarily. After intracoronary transfer, 1.3% to 2.6% of 18F-FDG-labeled unselected BMCs were detected in the infarcted myocardium, with the majority of activity found in the liver and spleen. In contrast, intravenous transfer showed no activity in the infarcted myocardium. CD34-enriched BMCs showed higher retention in the infarcted myocardium, with 14% to 39% of total activity detected, indicating more pronounced homing in the border zone of the infarct. The study concluded that 18F-FDG labeling and 3D PET imaging can effectively monitor BMC homing and biodistribution after therapeutic application in patients with AMI. The findings suggest that intracoronary transfer is more effective than intravenous transfer for BMC delivery, as it allows for better homing to the infarcted myocardium. CD34-enriched BMCs showed higher retention in the myocardium compared to unselected BMCs, indicating their potential for more effective tissue repair. The study also highlights the importance of monitoring BMC biodistribution to optimize therapeutic outcomes and understand the mechanisms of BMC action in AMI.