18F-BMS-747158-02 (Flurpiridaz F 18 / Flyrcado): A Comprehensive Report on a Novel Myocardial Perfusion PET Agent

1. Introduction to 18F-BMS-747158-02 (Flurpiridaz F 18 / Flyrcado)

18F-BMS-747158-02, more commonly known by its International Nonproprietary Name (INN) Flurpiridaz F 18 and marketed under the trade name Flyrcado, is a cyclotron-produced radioactive diagnostic agent developed for Positron Emission Tomography (PET) myocardial perfusion imaging (MPI).[1] This agent is indicated for use under both rest and stress conditions, induced either pharmacologically or through exercise, in adult patients with known or suspected coronary artery disease (CAD). Its primary purpose is the evaluation of myocardial ischemia and infarction.[1] Chemically, Flurpiridaz F 18 is a fluorine-18 (18F) labeled pyridaben derivative.[5] The incorporation of the 18F radioisotope is a critical feature, providing a physical half-life of approximately 109.7 to 109.8 minutes.[2] This characteristic offers distinct advantages over earlier PET MPI tracers.

The development of advanced MPI agents like Flurpiridaz F 18 is driven by the ongoing need to improve non-invasive cardiac diagnostics. Traditional PET tracers for MPI have often relied on short-lived isotopes, such as Rubidium-82 (82Rb) or Nitrogen-13 (13N) ammonia, which typically necessitate on-site production facilities (cyclotrons or generators), thereby limiting their widespread clinical availability.[7] Flurpiridaz F 18 addresses this limitation by utilizing the longer half-life of 18F. This extended half-life facilitates centralized production in regional cyclotrons and subsequent distribution to imaging centers as unit doses, similar to the established model for 18F-fluorodeoxyglucose (FDG).[7] Such logistical improvements significantly enhance the accessibility of advanced cardiac PET imaging.