Quantitative evaluation of 111In-antimyosin Fab myocardial (InAM) imaging was performed in 15 patients with acute myocardial infarction to evaluate which organ is the most appropriate for the control of myocardial accumulation, to compare the quantitative method with the conventional visual method, and to study which clinical indices correlate with the InAM quantitative evaluations. InAM images demonstrated the myocardium with 31 +/- 6 mean counts/pixel, lung with 14 +/- 4, upper mediastinum with 20 +/- 5, middle mediastinum with 26 +/- 5, and liver with 75 +/- 10. We considered the lung to be the most appropriate control organ for quantitative evaluations of InAM imaging, because it could be separated from the myocardium, and the measurement range was narrow. The InAM uptake index [IUI = (myocardial counts-lung counts)/lung counts] was calculated as the index of myocardial accumulation. Visual evaluations of myocardial accumulation on InAM images were classified into three grades. The IUI of grade 1 (slight) was 0.98 +/- 0.19, grade 2 (moderate) was 1.34 +/- 0.38, and grade 3 (severe) was 1.97 +/- 0.19. Visual grading was nearly in accordance with the IUI, although it was difficult to distinguish visually between grades 1 and 2. Measurement of wall motion by left ventriculography showed that reduced wall motion was associated with an IUI of 1.01 +/- 0.18 and dyskinesis with an IUI of 1.92 +/- 0.16, showing IUI can indicate regional myocardial damage. However, IUI was not correlated with indices of the overall left ventricular function, such as ejection fraction, cardiac index, and peak creatine kinase level.